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心血管重症监护病房肺动脉高压和右心衰竭的诊断和治疗。

Diagnosis and Management of Pulmonary Hypertension and Right Ventricular Failure in the Cardiovascular Intensive Care Unit.

机构信息

Pulmonary Hypertension, Right Heart Failure, CTEPH Program, Division of Cardiology, Temple University Hospital, 9th floor Parkinson Pavilion, 3401 North Broad Street, Philadelphia, PA 19140, USA.

Pulmonary and Critical Care, Temple University Hospital.

出版信息

Crit Care Clin. 2024 Jan;40(1):121-135. doi: 10.1016/j.ccc.2023.05.003. Epub 2023 Sep 7.

Abstract

Pulmonary hypertension (PH) encompasses a broad range of conditions, including pulmonary artery hypertension, left-sided heart disease, and pulmonary and thromboembolic disorders. Successful diagnosis and management rely on an integrated clinical assessment of the patient's physiology and right heart function. Right ventricular (RV) heart failure is often a result of PH, but may result from varying abnormalities in preload, afterload, and intrinsic myocardial dysfunction, which require distinct management strategies. Consideration of an individual's hemodynamic phenotype and physiologic circumstances is paramount in management of PH and RV failure, particularly when there is clinical instability in the intensive care setting.

摘要

肺动脉高压(PH)涵盖了广泛的病症,包括肺动脉高压、左心疾病以及肺部和血栓栓塞性疾病。成功的诊断和管理依赖于对患者生理和右心功能的综合临床评估。右心室(RV)衰竭通常是 PH 的结果,但也可能是由于前负荷、后负荷和内在心肌功能障碍的不同异常导致的,这需要不同的管理策略。在 PH 和 RV 衰竭的管理中,考虑个体的血流动力学表型和生理情况至关重要,特别是在重症监护环境中存在临床不稳定的情况下。

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