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心源性休克的血流动力学监测和超声心动图评估。

Hemodynamic monitoring and echocardiographic evaluation in cardiogenic shock.

机构信息

Servicio de Medicina Intensiva, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain.

Servicio de Medicina Intensiva, Hospital Universitario Virgen del Rocío, Sevilla, Spain.

出版信息

Med Intensiva (Engl Ed). 2024 Oct;48(10):602-613. doi: 10.1016/j.medine.2024.07.001. Epub 2024 Aug 2.

Abstract

Cardiogenic shock (CS) is characterized by the presence of a state of tissue hypoperfusion secondary to ventricular dysfunction. Hemodynamic monitoring allows us to obtain information about cardiovascular pathophysiology that will help us make the diagnosis and guide therapy in CS situations. The most used monitoring system in CS is the pulmonary artery catheter since it provides key hemodynamic variables in CS, such as cardiac output, pulmonary artery pressure, and pulmonary artery occlusion pressure. On the other hand, echocardiography makes it possible to obtain, at the bedside, anatomical and hemodynamic data that complement the information obtained through continuous monitoring devices. CS monitoring can be considered multimodal and integrative by including hemodynamic, metabolic, and echocardiographic parameters that allow describing the characteristics of CS and guiding therapeutic interventions during hemodynamic resuscitation.

摘要

心原性休克(CS)的特征是心室功能障碍导致组织低灌注状态。血流动力学监测可提供有关心血管病理生理学的信息,有助于我们做出诊断,并指导 CS 情况下的治疗。CS 中最常使用的监测系统是肺动脉导管,因为它提供 CS 中的关键血流动力学变量,如心输出量、肺动脉压和肺动脉闭塞压。另一方面,超声心动图可在床边获得解剖和血流动力学数据,补充通过连续监测设备获得的信息。CS 监测可通过包括血流动力学、代谢和超声心动图参数来实现多模态和综合,这些参数可描述 CS 的特征,并指导血流动力学复苏期间的治疗干预。

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