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The Journal of critical illness最新文献

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The technique of slow continuous ultrafiltration. Steps to maintain fluid balance without hemodynamic instability. 慢速连续超滤技术。维持体液平衡，避免血流动力学不稳定的步骤。
The Journal of critical illness
Pub Date : 1991-03-01
R H Merrill

Slow continuous ultrafiltration (SCUF) is ideally suited for fluid overloaded patients with renal insufficiency, and for patients who need intravenous fluids in amounts that exceed renal excretory capacity. Like other methods of continuous ultrafiltration, including CAVH and CAVHD, SCUF can be performed in the intensive care unit with a minimum of equipment. During SCUF, arterial blood (usually from the femoral artery) is passed through a hollow-fiber hemofilter; an ultrafiltrate of serum collects at a rate that is determined by the patient's blood pressure. Replacement of intravenous fluids is generally not required with SCUF. The amount of ultrafiltrate that is removed can be titrated to achieve the desired fluid balance.

慢速连续超滤(SCUF)非常适合肾功能不全的液体超载患者，以及需要静脉输液量超过肾脏排泄能力的患者。与其他连续超滤方法(包括CAVH和CAVHD)一样，SCUF可以在重症监护病房进行，设备最少。在SCUF期间，动脉血(通常来自股动脉)通过中空纤维血液过滤器;血清超滤液的收集速度由病人的血压决定。scf一般不需要更换静脉输液。可以滴定去除的超滤液的量以达到所需的流体平衡。
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引用次数: 0
PTCA update: is your patient now a candidate? Even complex multivessel lesions may succumb to balloon dilation. PTCA更新:你的病人现在是候选者吗?即使是复杂的多血管病变也可能屈服于球囊扩张。
The Journal of critical illness
Pub Date : 1991-02-01
P L Cole, R J Krone

Indications for PTCA continue to grow. In complex multivessel lesions, PTCA now has high primary success and low complication rates. Dilation of chronic total occlusions is less successful than in subtotal occlusions but may relieve angina in some patients. Occluded saphenous vein grafts can be dilated and long-term patency achieved--particularly in grafts implanted for less than 36 months. Restenosis remains a major drawback; antithrombotic therapy (with heparin during PTCA and aspirin thereafter) is recommended. PTCA is a useful adjunct in acute myocardial infarction when thrombolytic therapy fails or is contraindicated, or when significant luminal narrowing remains after thrombolysis. Investigational devices--atherectomy catheters, lasers or laser balloons, and intracoronary stents--may further expand the role of PTCA.

PTCA的适应症持续增加。在复杂的多血管病变中，PTCA的原发性成功率高，并发症发生率低。慢性全闭塞的扩张不如次全闭塞成功，但可以缓解一些患者的心绞痛。闭塞的隐静脉移植物可以扩张并实现长期通畅，特别是移植时间少于36个月的移植物。再狭窄仍然是主要的缺点;建议使用抗血栓治疗(PTCA期间使用肝素，之后使用阿司匹林)。当溶栓治疗失败或有禁忌症时，或溶栓后仍有明显的管腔狭窄时，PTCA是一种有用的辅助手段。研究设备——动脉粥样硬化切除术导管、激光或激光球囊以及冠状动脉内支架——可能进一步扩大PTCA的作用。
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引用次数: 0
The technique of percutaneous transluminal coronary angioplasty. Uses, abuses, training requirements, benefits, complications. 经皮冠状动脉腔内成形术技术。用途、滥用、培训要求、好处、并发症。
The Journal of critical illness
Pub Date : 1991-02-01
H J Swan

Like coronary artery bypass grafting, PTCA is used to manage multilesion and multivessel disease, new complete occlusions, and partial occlusions of saphenous vein or internal mammary artery grafts. PTCA is contraindicated for patients with a significant obstructive lesion in the left main coronary artery or with severe diffuse atherosclerosis. In determining whether this procedure provides the best treatment option, the risk of abrupt vessel closure, restenosis, MI, or incomplete revascularization must be considered. Guidelines for the performance of PTCA and physician and institutional responsibilities have been established; these guidelines must be regarded as necessary criteria for wide adoption.

与冠状动脉旁路移植术一样，PTCA用于治疗多病变、多血管疾病、新的完全闭塞、部分闭塞的隐静脉或乳腺内动脉移植物。PTCA不适用于左冠状动脉主干有明显阻塞性病变或严重弥漫性动脉粥样硬化的患者。在确定该手术是否为最佳治疗选择时，必须考虑血管突然关闭、再狭窄、心肌梗死或不完全血运重建的风险。已经建立了PTCA的执行以及医生和机构责任的指导方针;这些准则必须被视为广泛采用的必要标准。
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引用次数: 0
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