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突尼斯某中心肺动脉高压的血流动力学特征

Hemodynamic profile of pulmonary arterial hypertension in a Tunisian center.

作者信息

Jamoussi Amira, Ben Mrad Nacef, Rachdi Emna, Jarraya Fatma, Zairi Sarra, Ben Romdhane Kais, Besbes Mohamed, Ayed Samia, Ben Khelil Jalila

机构信息

Medical Intensive Care Unit, Abderrahmen Mami hospital, Ariana, Tunisia/ Research Unit for Respiratory Failure and Mechanical Ventilation UR22SP01, Ministry of higher education and scientific research.

Thoracic Surgery, Abderrahmen Mami hospital, Ariana. University of Tunis EI Manar, Faculty of Medicine of Tunis, Tunisia.

出版信息

Tunis Med. 2023 Oct 5;101(10):751-755.

PMID:38465755
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11392018/
Abstract

INTRODUCTION

Pulmonary hypertension (PH) management can only be conceived in a specialized center. We aimed to report the experience of a Tunisian ICU about PH invasive hemodynamic exploration and to describe consequent therapeutic decisions.

METHODS

Retrospective descriptive study including all patients admitted to the medical ICU of Abderrahmen Mami Hospital for right heart catheterization (RHC), between 2005 and 2019 as part of the investigation of PH. Patients' characteristics, procedure safety and arising therapeutic decisions were then reported.

RESULTS

Forty patients were admitted for hemodynamic evaluation. RHC confirmed PH in 31 patients and exploration was then completed with NO reactivity test. Mean age was 41.3±15 years, gender ratio M/F was 1.06. PH was classified into: group 1 (n=13), group 2 (n=14), group 4 (n=2) and group 5 (n=2). NO vasoreactivity test was positive in 50% of post-capillary PH and in 28% of pre-capillary PH. The therapeutic decision following the reversibility test was: prescription of calcium channel blockers (n=5), a specific pulmonary vasodilator (n=10), operability (n=6), heart-lung transplant (n=3) and therapeutic abstention (n=7). Two minor complications were reported.

CONCLUSION

The medical ICU in Abderrahmen Mami Hospital represents an experienced team in hemodynamic investigations despite low annual RHC number. NO reactivity test is an indispensable tool that enables important decisions during PH management.

摘要

引言

肺动脉高压（PH）的管理只能在专业中心进行。我们旨在报告一家突尼斯重症监护病房（ICU）关于PH有创血流动力学检查的经验，并描述由此产生的治疗决策。

方法

回顾性描述性研究，纳入2005年至2019年间因PH调查而入住阿卜杜勒拉赫曼·马米医院内科ICU进行右心导管检查（RHC）的所有患者。然后报告患者的特征、操作安全性及由此产生的治疗决策。

结果

40例患者接受了血流动力学评估。RHC确诊31例PH患者，随后通过一氧化氮反应性测试完成检查。平均年龄为41.3±15岁，男女比例为1.06。PH分为：1组（n=13）、2组（n=14）、4组（n=2）和5组（n=2）。50%的毛细血管后PH和28%的毛细血管前PH的一氧化氮血管反应性测试呈阳性。可逆性测试后的治疗决策为：开具钙通道阻滞剂（n=5）、特定的肺血管扩张剂（n=10）、可手术性（n=6）、心肺移植（n=3）和治疗放弃（n=7）。报告了2例轻微并发症。

结论

尽管每年RHC数量较少，但阿卜杜勒拉赫曼·马米医院的内科ICU在血流动力学检查方面拥有经验丰富的团队。一氧化氮反应性测试是PH管理过程中做出重要决策不可或缺的工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63e8/11392018/314e40c34068/capture7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63e8/11392018/02517cef7aee/capture1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63e8/11392018/239d38e97a1a/capture2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63e8/11392018/7595f9fe6e24/capture3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63e8/11392018/02beeaa89213/capture4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63e8/11392018/39e8df8d5150/capture5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63e8/11392018/314e40c34068/capture7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63e8/11392018/314e40c34068/capture7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63e8/11392018/02517cef7aee/capture1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63e8/11392018/239d38e97a1a/capture2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63e8/11392018/7595f9fe6e24/capture3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63e8/11392018/02beeaa89213/capture4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63e8/11392018/39e8df8d5150/capture5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63e8/11392018/314e40c34068/capture7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63e8/11392018/314e40c34068/capture7.jpg

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