Hall Eric J, Papolos Alexander I, Miller P Elliott, Barnett Christopher F, Kenigsberg Benjamin B
Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center Dallas, TX.
Division of Cardiology and Department of Critical Care, MedStar Washington Hospital Center Washington, DC.
US Cardiol. 2024 Aug 13;18:e11. doi: 10.15420/usc.2024.16. eCollection 2024.
Patients undergoing cardiac surgery experience significant physiologic derangements that place them at risk for multiple shock phenotypes. Any combination of cardiogenic, obstructive, hemorrhagic, or vasoplegic shock occurs commonly in post-cardiotomy patients. The approach to the diagnosis and management of these shock states has many facets that are distinct compared to non-surgical cardiac intensive care unit patients. Additionally, the approach to and associated outcomes of cardiac arrest in the post-cardiotomy population are uniquely characterized by emergent bedside resternotomy if the circulation is not immediately restored. This review focuses on the unique aspects of the diagnosis and management of post-cardiotomy shock.
接受心脏手术的患者会经历显著的生理紊乱,这使他们面临多种休克表型的风险。心源性、梗阻性、出血性或血管麻痹性休克的任何组合在心脏切开术后患者中都很常见。与非手术心脏重症监护病房患者相比,这些休克状态的诊断和管理方法有许多不同的方面。此外,如果循环不能立即恢复,心脏切开术后人群心脏骤停的处理方法和相关结果具有床边紧急再次开胸手术的独特特征。本综述重点关注心脏切开术后休克诊断和管理的独特方面。