心血管手术术后经胸超声心动图血流动力学监测

Julio C. Durán-Pérez, Víctor Pérez-Alvear, Luis Calderón-Orozco
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引用次数: 0

摘要

目的:描述经胸超声心动图测量的不同心血管手术方式患者的血流动力学变量。材料和方法:观察性、描述性、前瞻性、单中心研究。采用经胸超声心动图进行血流动力学测量。计算收缩力变量:心输出量和心脏指数,容积反应变量:左心室流出道(LVOT)流速变化,肺动脉闭塞压(POAP)计算。我们描述了发现的不同血流动力学模式和基于这些发现的治疗改变的频率。结果:共研究27例患者。在25%的患者中,由于获得良好超声窗口的技术困难而无法进行研究。29.6%的患者心输出量低,59.25%的患者心输出量正常,11.1%的患者心输出量高。通过分析LVOT流量变化百分比,发现59.25%的患者对容积无反应。14.81%的计算POAP大于18。在74.1%的患者中,根据血流动力学结果做出了一些行为改变。结论:本研究强调了非侵入性技术在重症监护患者血流动力学评估中的重要性。使用该技术,可以对主要血流动力学变量进行评估,建立可靠的诊断并确定治疗计划。
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Monitorización hemodinámica por ecocardiografía trans-torácica en pacientes en posoperatorio de cirugía cardiovascular
Objective: To describe hemodynamic variables measured by transthoracic echocardiography in patients undergoing different cardiovascular surgery procedures. Materials and Methods: Observational, descriptive, prospective, single center study. Hemodynamic measurement was performed with the use of transthoracic echocardiography. Contractility variables were calculated: Cardiac output and cardiac index, volume response variables: Variation of flow velocity through the left ventricular outflow tract (LVOT), and calculation of the Pulmonary Arterial Occlusion Pressure (POAP). We described the different hemodynamic patterns found and the frequency of therapeutic changes based on these findings. Results: A total of 27 patients were studied. In 25% of patients, the study could not be performed due to technical difficulties in obtaining a good ultrasound window. In 29.6% of patients, low cardiac output was found, in 59.25% normal cardiac output was found, and in 11.1% high cardiac output was found. 59.25% of the patients were found not to respond to volume by analyzing the percentage of variation of flow through the LVOT. In 14,81%, a calculated POAP greater than 18 was found. In 74,1% of the patients, some behavioral change was made based on the hemodynamic findings. Conclusions: This study highlights the importance of alternative, non-invasive techniques in the hemodynamic evaluation of patients in the Intensive Care setting. With this technique it is possible to perform an evaluation of the main hemodynamic variables, establish a reliable diagnosis and determine a therapeutic plan.
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来源期刊
Revista Chilena de Anestesia
Revista Chilena de Anestesia Medicine-Anesthesiology and Pain Medicine
CiteScore
0.30
自引率
0.00%
发文量
93
审稿时长
10 weeks
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