Hudson L D
Geriatrics. 1976 Nov;31(11):61-4.
Arrhythmias are as likely to strike patients with acute respiratory failure as patients with acute myocardial infarction. Both supraventricular and ventricular types were detected in half or more of the patients in two recent studies. Ventricular arrhythmias have a particularly bleak prognosis, since they often deteriorate into ventricular fibrillation or cardiac arrest. The exact causes of these arrhythmias are still a mystery, but metabolic abnormalities associated with respiratory failure are highly suspect. These disturbances can disrupt the transmembrane action potential of cardiac conducting tissue, causing electrophysiologic phenomena known to trigger arrhythmias. Until a specific etiology is confirmed, treatment should focus on identifying and correcting possible metabolic causes. Congestive heart failure--itself a cause of arrhythmias--also should be treated. Cardioversion and antiarrhythmic drugs should be used only in life-threatening situations.
心律失常在急性呼吸衰竭患者中发生的可能性与急性心肌梗死患者一样高。在最近的两项研究中，超过半数的患者检测出有室上性和室性心律失常。室性心律失常的预后尤其不佳，因为它们常常恶化为心室颤动或心脏骤停。这些心律失常的确切病因仍是个谜，但与呼吸衰竭相关的代谢异常很值得怀疑。这些紊乱会破坏心脏传导组织的跨膜动作电位，引发已知会触发心律失常的电生理现象。在确认具体病因之前，治疗应着重于识别和纠正可能的代谢原因。充血性心力衰竭本身就是心律失常的一个病因，也应进行治疗。心脏复律和抗心律失常药物仅应在危及生命的情况下使用。
