Friedman W F, George B L
J Pediatr. 1985 May;106(5):697-706. doi: 10.1016/s0022-3476(85)80339-5.
We have not emphasized the traditional approaches to the treatment of congestive heart failure, because there is abundant literature detailing the importance of rest and comfort for the patient, reduction of solute load, and administration of digitalis and diuretics. Instead, we have sought to emphasize the therapeutic interventions that are aimed at changing the mechanical loading conditions of the heart. Treatment expectations must be viewed within an age- or maturity-dependent framework. Thus, when a preterm or full-term newborn infant requires cardiocirculatory support, diminished cardiac reserve limits the benefits derived from diverse treatment methods. This unique fragility of the developing heart and circulation places a premium on the astute manipulation of all of the factors that determine optimum cardiovascular adaptation to stress. Beyond infancy, although cardiovascular reserve increases, it remains imperative to modify therapy by using cardioactive drugs that deal specifically with the separate mechanical and contractile variables to assure optimum survival.
我们没有强调治疗充血性心力衰竭的传统方法，因为有大量文献详细阐述了让患者休息和保持舒适、减少溶质负荷以及使用洋地黄和利尿剂的重要性。相反，我们试图强调旨在改变心脏机械负荷状况的治疗干预措施。治疗期望必须在年龄或成熟度相关的框架内看待。因此，当早产儿或足月儿需要心脏循环支持时，心脏储备功能减弱会限制各种治疗方法所带来的益处。发育中的心脏和循环系统的这种独特脆弱性使得精准操控所有决定心血管对压力最佳适应的因素变得至关重要。在婴儿期之后，尽管心血管储备增加，但通过使用专门针对不同机械和收缩变量的心血管活性药物来调整治疗方案以确保最佳生存率仍然很有必要。
