心脏外科围术期的重症监护
Perioperative intensive care for cardiac surgery patients
Received date: 2023-07-26
Online published: 2024-01-04
刘华, 罗明豪, 屠国伟, 罗哲 . 心脏外科围术期的重症监护[J]. 外科理论与实践, 2023 , 28(05) : 409 -414 . DOI: 10.16139/j.1007-9610.2023.05.03
The rapid development of perioperative intensive care in cardiac surgery has greatly improved the prognosis for patients undergoing major cardiovascular surgery. In the field of hemodynamics, besides traditional methods, such as a variety of arterial catheters and central venous catheter, thermodilution and echocardiography have gradually becoming routines in hemodynamic monitoring, but their clinical values require further investigation. At the same time, optimizing micro-circulation, in order to meet the demand of oxygen and metabolism, is the goal of hemodynamic resuscitation. The management of V-A extracorporeal membrane oxygenation (ECMO) in the perioperative period of cardiac surgery depends on persistent hemodynamic monitoring. Volume management, vasoactive drugs, inotropes and vasodilators are still keys in pharmacological management. In addition, many mechanical circulatory assist devices have brought more treatments and hope for end-stage heart failure and severe cardiopulmonary dysfunction.
Key words： Intensive care; Cardiac surgery; Hemodynamics; Mechanical circulatory
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