Vaska P L
Sioux Valley Hospital, Sioux Falls, SD.
Am J Crit Care. 1993 Mar;2(2):145-54; quiz 155-6.
Infection is the primary cause of morbidity and mortality following cardiac transplantation because of the strict immunosuppressive regimens patients follow. In the immediate postoperative phase, patients are more susceptible to infection because of interruption of their external barriers to infection. Cardiac transplant recipients are most likely to succumb to infections caused by cytomegalovirus, Epstein-Barr virus and bacterial organisms, especially staphylococcus. Fungal, protozoal and herpes simplex infections are also frequently troublesome to the transplant recipient. Critical care clinicians can control the incidence of infection in the cardiac transplant population by initiating measures to maintain external barriers, monitoring the patient for early signs of infection, and instituting appropriate isolation techniques.
由于患者遵循严格的免疫抑制方案,感染是心脏移植后发病和死亡的主要原因。在术后即刻阶段,由于感染的外部屏障中断,患者更容易受到感染。心脏移植受者最容易死于由巨细胞病毒、爱泼斯坦-巴尔病毒和细菌病原体引起的感染,尤其是葡萄球菌。真菌、原生动物和单纯疱疹感染对移植受者来说也常常很棘手。重症监护临床医生可以通过采取措施维持外部屏障、监测患者感染的早期迹象以及采用适当的隔离技术来控制心脏移植人群中的感染发生率。