医学
心脏压塞
心包积液
卫生棉条
心脏病学
心包
心包穿刺术
内科学
心包液
休克(循环)
心室
中心静脉压
血管内容积状态
血压
血流动力学
心率
作者
Laurent Bodson,Koceïla Bouferrache,Antoine Vieillard‐Baron
出处
期刊:Current Opinion in Critical Care
[Ovid Technologies (Wolters Kluwer)]
日期:2011-10-01
卷期号:17 (5): 416-424
被引量:46
标识
DOI:10.1097/mcc.0b013e3283491f27
摘要
Purpose of review To re-emphasize the epidemiology, pathophysiology, diagnosis, and treatment of cardiac tamponade. Recent findings Cardiac tamponade is a cause of obstructive shock. Incidence of cardiac tamponade is poorly documented. In cardiac tamponade, the pericardial pressure may reach 15–20 mmHg, leading to an equalization of pressures into the cardiac chambers and to a huge decrease in the systemic venous return. The right atrial transmural pressure becomes negligible. A competition between the right atrium and the right ventricle and between both ventricles is occurring. Deep inspiration allows the patients to maintain the systemic venous return at a certain level. Echocardiography is the key tool to diagnose a pericardial effusion, to detect its bad-tolerance, and to guide the treatment. In some situations following cardiac surgery, transesophageal echocardiography is mandatory. Treatment aims to restore a ‘normal’ blood pressure by fluid loading (with caution) and catecholamines and to drain the pericardium in emergency. Summary Cardiac tamponade is responsible for an obstructive shock. Causes of pericardial effusion are numerous. Echocardiography is the fundamental tool for the diagnosis and therapeutic management. Volume resuscitation and catecholamines are temporary treatments, pericardial drainage remaining the only effective treatment.
科研通智能强力驱动
Strongly Powered by AbleSci AI