Goal-directed therapy in cardiovascular surgery: A case series study

IF 1.2 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
Nader Givtaj, Elnaz Hosseinzadeh, Fatemeh Shima Hadipourzadeh, Zahra Faritous, Mohammad Hasan Askari, Maryam Ghanbari Garekani
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引用次数: 0

Abstract

Hemodynamic and intravascular volume monitoring has been utilized and significantly improved thanks to the technology revolution. Goal-Directed Therapy (GDT) derived from this advanced monitoring is beneficial for complex surgeries, and it shifted the medical approaches from static therapy to more personalized functional treatments. Conventional monitoring methods such as blood pressure, heart rate, urinary output, and central venous pressure are commonly used. However, studies have shown these routine parameters often cannot precisely estimate the quality of tissue perfusion. Tissue hypoperfusion and hypoxia play a crucial role in initiating a systemic inflammatory response after prolonged surgeries, resulting in unstable hemodynamic condition of the patients. Several studies reported the importance of GDT in non-cardiac surgeries and there are few reports on cardiac surgeries. However, tissue perfusion and fluid management are more critical in complex and prolonged cardiovascular surgeries to avoid complications such as low cardiac output syndrome and renal or pulmonary dysfunction. Different advanced hemodynamic monitorings have been utilized perioperatively in cardiac surgery to help decision-making on inotrope and fluid management. In this article we present 5 cases of usefulness hemodynamic monitoring in patients who underwent cardiovascular surgeries.
目标导向治疗在心血管外科:一个病例系列研究
由于技术革命,血液动力学和血管内容量监测已得到利用并显著改善。基于这种先进监测的目标导向治疗(GDT)对复杂手术是有益的,它将医学方法从静态治疗转变为更个性化的功能治疗。常用的常规监测方法包括血压、心率、尿量、中心静脉压等。然而,研究表明,这些常规参数往往不能准确估计组织灌注质量。长期手术后,组织灌注不足和缺氧在引发全身炎症反应中起着至关重要的作用,导致患者血流动力学状况不稳定。一些研究报道了GDT在非心脏手术中的重要性,但关于心脏手术的报道很少。然而,在复杂和长期的心血管手术中,组织灌注和液体管理更为关键,以避免低心输出量综合征和肾或肺功能障碍等并发症。不同的先进的血流动力学监测已被用于围手术期心脏手术,以帮助决策的肌力和液体管理。在这篇文章中,我们提出了5例有用的血流动力学监测的病人接受了心血管手术。
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来源期刊
Journal of Cardiovascular and Thoracic Research
Journal of Cardiovascular and Thoracic Research CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
2.00
自引率
0.00%
发文量
22
审稿时长
7 weeks
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