Cairns J A
Can Med Assoc J. 1979 Oct 6;121(7):905-10.
The main cause of in-hospital death in patients with acute myocardial infarction is the "power failure syndrome". Hemodynamic monitoring provides precise and current data on the filling and output status of the left ventricle and, when indicated, the right ventricle. The information obtained is used to determine the hemodynamic status more precisely than is possible from conventional clinical assessment. It permits categorization of patients by hemodynamic status; the hemodynamic subset classification of Forrester, Diamond and Swan is a powerful tool in guiding therapy and establishing prognosis in individual patients. In addition to guiding the initiation of therapy, hemodynamic monitoring is useful in the continuing assessment of potent and complex treatment. This therapy is directed at resolving hemodynamic derangements without unfavourably altering the myocardial oxygen supply-demand relationship. Specific clinical indications for hemodynamic monitoring may include confusing or complicated clinical situations in which diagnostic problems exist, complicating mechanical derangements, severe congestive heart failure, cardiogenic shock and clinical research in acute myocardial infarction.
急性心肌梗死患者院内死亡的主要原因是“心力衰竭综合征”。血流动力学监测可提供关于左心室以及必要时右心室的充盈和输出状态的精确且实时的数据。所获得的信息用于比传统临床评估更精确地确定血流动力学状态。它允许根据血流动力学状态对患者进行分类；Forrester、Diamond和Swan的血流动力学亚组分类是指导个体患者治疗和确定预后的有力工具。除了指导治疗的启动外，血流动力学监测在持续评估强效和复杂治疗方面也很有用。这种治疗旨在解决血流动力学紊乱，同时不不利地改变心肌氧供需关系。血流动力学监测的具体临床指征可能包括存在诊断问题的复杂或混淆的临床情况、复杂的机械紊乱、严重充血性心力衰竭、心源性休克以及急性心肌梗死的临床研究。
