无创心功能监测在重症心力衰竭患者中的应用
摘要
目的观察无创心功能监测(USCOM)在重症心力衰竭患者中的应用情况。方法 62例重症心力衰竭患者,其中28例患者应用USCOM进行心功能测定,为观察组,另外34例患者未应用USCOM,使用其他方法监测心功能为对照组,患者均给予重症心力衰竭常规治疗。分别对两组间24 h与48 h的心脏指数(CI)、心排出量(CO)、左室射血分数(LVEF)、脑钠肽(BNP)值及应用呼吸机时间、重症监护室(ICU)住院时间和28 d病死率等情况进行比较分析。结果观察组48 h CI、CO、LVEF均高于对照组(P<0.05)。与对照组比较,观察组应用呼吸机时间和ICU住院时间较短、28 d病死率更低(均P<0.05)。结论 USCOM用于重症心力衰竭患者心功能监测,能够更加及时评价心功能转归;对于提高心力衰竭纠正效率、缩短住院时间及改善预后有较大帮助。
引文
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2 Obonyo N,Maitland K.Fluid management of shock in severe malnutrition:what is the evidence for current guidelines and what lessons have been learned from clinical studies and trials in other pediatric populations[J]?Food Nutr Bull,2014;35(2 Suppl):71-8.
3 Peixoto AJ,Alpern RJ.Treatment of severe metabolic alkalosis in a patient with congestive heart failure[J].Am J Kidney Dis Official J National Kidney Foundat,2013;61(5):822-7.
4 Zheng SL,Chan FT,Nabeebaccus AA,et al.Drug treatment effects on outcomes in heart failure with preserved ejection fraction:a systematic review and meta-analysis[J].Heart,2018;104(5):407-15.
5 Oud L.Epidemiology,characteristics,and outcomes of ICU-managed homeless patients:a population-based study[J].Biomed Res Int,2018;2018(2):1-11.
6 Krishnan S,Moghekar A,Duggal A,et al.Radiation exposure in the medical ICU:predictors and characteristics[J].Chest,2018;153(5):1160-8.
7 Cioccari L,Zante B,Bloch A,et al.Effects of hemodynamic monitoring using a single-use transesophageal echocardiography probe in critically ill patients-study protocol for a randomized controlled trial[J].Trials,2018;19(1):362.
8 Critchley LA,Huang L.USCOM-window to the circulation:utility of supra-sternal Doppler in an elderly anaesthetized patient for a robotic cystectomy[J].J Clin Monit Comput,2014;28(1):83-93.
9 Churpek MM,Snyder A,Han X,et al.Quick sepsis-related organ failure assessment,systemic inflammatory response syndrome,and early warning scores for detecting clinical deterioration in infected patients outside the intensive care unit[J].Am J Resp Crit Care Med,2017;195(7):906.
10 Omar HR,Guglin M.Post-discharge rise in BNP and rehospitalization for heart failure[J].Herz,2018;(4):1-5.
11 Kingma JG,Simard D,Rouleau JR.Influence of cardiac nerve status on cardiovascular regulation and cardioprotection[J].World J Cardiol,2017;9(6):508-20.
12 Hao JJ.Protection and mechanism of low dose enteral nutrition on organ function in patients with cardiac and renal syndrome[J].Med Innovation China,2016;13(22):032-5.
13 Wongsirimetheekul T,Khositseth A,Lertbunrian R.Non-invasive cardiac output assessment in critically ill paediatric patients[J].Acta Cardiol,2014;69(2):167-73.