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[急诊科心血管急症患者的监测:德国心脏病学会(DGK)、德国重症医学与急救医学学会(DGINA)和德国介入与重症监护医学学会(DGIIN)的共识文件]

[Monitoring of emergency cardiovascular patients in the emergency department : Consensus paper of the DGK, DGINA and DGIIN].

作者信息

Jung Christian, Boeken Udo, Schulze P Christian, Frantz Stefan, Hermes Carsten, Kill Clemens, Marohl Ranka, Voigt Ingo, Wolfrum Sebastian, Bernhard Michael, Michels Guido

机构信息

Klinik für Kardiologie, Pneumologie und Angiologie des Universitätsklinikums Düsseldorf, Heinrich-Heine-Universität Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Deutschland.

Klinik für Herzchirurgie des Universitätsklinikums Düsseldorf, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Deutschland.

出版信息

Med Klin Intensivmed Notfmed. 2023 Dec;118(Suppl 1):47-58. doi: 10.1007/s00063-023-01069-w. Epub 2023 Sep 15.

Abstract

Patients with potential or proven cardiovascular diseases represent a relevant proportion of the total spectrum in the emergency department. Their monitoring for cardiovascular surveillance until the diagnostics and acute treatment are initiated, often poses an interdisciplinary and interprofessional challenge, because resources are limited, nevertheless a high level of patient safety has to be ensured and the correct procedure has a major prognostic significance. This consensus paper provides an overview of the practical implementation, the modalities of monitoring and the application in a selection of cardiovascular diagnoses. The article provides specific comments on the clinical presentations of acute coronary syndrome, acute heart failure, cardiogenic shock, hypertensive emergency events, syncope, acute pulmonary embolism and cardiac arrhythmia. The level of evidence is generally low as no randomized trials are available on this topic. The recommendations are intended to supplement or establish local standards and to assist all physicians, nursing personnel and the patients to be treated in making decisions about monitoring in the emergency department.

摘要

潜在或已确诊心血管疾病的患者在急诊科患者总数中占相当比例。在开始诊断和急性治疗之前,对他们进行心血管监测往往构成跨学科和跨专业的挑战,因为资源有限,但必须确保高水平的患者安全,且正确的程序具有重大的预后意义。本共识文件概述了实际实施情况、监测方式以及在一系列心血管诊断中的应用。本文针对急性冠状动脉综合征、急性心力衰竭、心源性休克、高血压急症、晕厥、急性肺栓塞和心律失常的临床表现给出了具体意见。由于该主题尚无随机试验,证据水平普遍较低。这些建议旨在补充或制定当地标准,并协助所有医生、护理人员以及待治疗患者在急诊科做出有关监测的决策。

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