每日一题_2022.1.13

A 68-year-old man is undergoing a mitral valve replacement(二尖瓣置换术) for severe mitral regurgitation. He is unable to be weaned from cardiopulmonary bypass(体外循环). An intra-aortic balloon pump (IABP) is placed and he is able to separate from the heart-lung machine. The IABP pressure tracing in the ICU is shown below.

每日一题_2022.1.13

Which of the following is the necessary correction?

A. No adjustment is necessary; the IABP is augmenting correctly.

B. Set the balloon pump to trigger later; the tracing suggests early balloon inflation.

C. Set the balloon pump to trigger earlier; the tracing suggests late balloon inflation.

D. Set the balloon pump to deflate earlier; the tracing suggests late balloon deflation.

主动脉内球囊反搏(IABP)是一种机械循环装置,已被用于支持心肌梗死心源性休克、顽固性室性心律失常和急性失代偿性心力衰竭患者。IABP充气和放气的时间对于通过增加冠状动脉灌注和降低后负荷促进血流动力学支持至关重要。心电图和体循环主动脉压波形可用于触发IABP。在窦性心律患者中,IABP被设定为在ECG上R波峰值时充盈T波中间和放气,分别对应于舒张期和收缩期的开始。在主动脉压力波形触发模式下,球囊用对应于主动脉瓣关闭的二腔切迹充气,并在代表主动脉瓣开放的收缩期动脉上升前放气。
描述的压力波形显示舒张期增强和无二色切迹。这表明球囊充盈过早。早期球囊扩张通过增加后负荷和心肌需氧量损害收缩功能。

References:

  1. Trost JC, Hillis LD. Intra-aortic balloon counterpulsation. Am J Cardiol. 2006 May 1; 97(9):1391-1398.
  2. Maccioli GA, Lucas WJ, Norfleet EA. The intra-aortic balloon pump: a review. J Cardiothorac Anesth. 1988 Jun;2(3); 365-373.

补充内容:

更多内容可以访问:IABP操作手册

原创文章(本站视频密码:66668888),作者:xujunzju,如若转载,请注明出处:https://zyicu.cn/?p=8698

发表评论

您的电子邮箱地址不会被公开。 必填项已用*标注

联系我们
联系我们
捐赠本站
捐赠本站
返回顶部