Echo-Doppler demonstration of acute cor pulmonale at the bedside in the medical intensive care unit
Echo-Doppler demonstration of acute cor pulmonale at the bedside in the medical intensive care unit
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DOI：
10.1164/rccm.200202-146cc
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发表时间：
2002-11-15
影响因子：
24.7
通讯作者：
Jardin, F
中科院分区：
文献类型：
--
作者：
Vieillard-Baron, A;Prin, S;Jardin, F
在很长一段时间里，唯一可用的程序是最密集的同时进行的。当右室收缩超负荷时，右室收缩时间延长，以至于监护室医生在床边评估心功能时进行了右心导管术。右心导管术允许右室在左室收缩结束后继续推进(2)。此时，在很短的时间内，压力和流量的压力测量和派生变量的计算。但这些都需要适当的右室腔整合可以克服左心室的整合，并逆转跨室间隔压力梯度，以获得准确的诊断。换句话说，通过右心导管术获得的定量评估的目的是使隔壁向左移位(图1)。左、右心室都被封闭在一个僵硬的包络中，是为了提供对心功能的间接定性估计。心包。两个心室的舒张末容积相似--相反，超声心动图的评估是直接定性的：UMES，通过简单的实时可视化正常心包空间的动力学和大小，在一个房间内没有可供扩大的自由空间。因此，当右室舒张期心腔时，有经验的重症监护医生超负荷，只有在足够的超声心动图背景下才能发生右室扩大，可以立即建立用于左室的空间的费用，这是一种功能诊断。因此受到限制。这篇临床综述旨在阐明超声心动图为床边心功能评估提供的有价值的信息。为此，我们选择了一种主要的超声心动图描述，特别是明确的临床环境，急性肺源性心脏病。用来研究右室功能
For a long time, the only procedure available to the intensive most at the same time. When right ventricular systole is overloaded, right ventricular contraction is prolonged, so that the care unit physician to assess cardiac function at the bedside was right heart catheterization. Right heart catheterization allows right ventricle can continue to push after the left ventricle systole has ended (2). At this time, and for a short instant, the pressure measurements of pressure and flow and the computation of derived variables. But these require an appropriate integration in the right ventricular cavity may overcome that of the left ventricle, and reversal of the trans-septal pressure gradient imto obtain an accurate diagnosis. In other words, the aim of the quantitative evaluation obtained by right heart catheterization poses leftward displacement of the septal wall (Figure 1). Left and right ventricles are both enclosed in a stiff envelope, is to provide an indirect qualitative estimate of cardiac function. the pericardium. Both ventricles have similar end-diastolic vol-Conversely, echocardiographic evaluation is directly qualitative: umes, and there is no free space for ventricular dilatation in a by a simple visualization in real time of the kinetics and size of normal pericardial space. Thus, when right ventricular diastole cardiac cavities, an experienced critical care intensivist with a is overloaded, right ventricular enlargement can occur only at sufficient echocardiographic background can immediately estabthe expense of the space devoted to the left ventricle, which is lish a functional diagnosis. thus restricted. This clinical review aims at illustrating the valuable information provided by echocardiography for the assessment of cardiac function at the bedside. For that purpose, we have chosen a DESCRIPTION OF MAIN ECHOCARDIOGRAPHIC VIEWS particular and well-defined clinical setting, acute cor pulmonale. USED TO STUDY RIGHT VENTRICULAR FUNCTION IN