Cardiopulmonary manifestations of hantavirus pulmonary syndrome
Cardiopulmonary manifestations of hantavirus pulmonary syndrome
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DOI：
10.1097/00003246-199602000-00012
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发表时间：
1996-02-01
影响因子：
8.8
通讯作者：
Levy, H
中科院分区：
文献类型：
--
作者：
Hallin, GW;Simpson, SQ;Levy, H
目的：描述美国西南部一组新发现的汉他病毒感染患者的临床特征。设计：病例系列。设置：三级转诊中心。患者：1993年5月1日至1994年1月1日期间在新墨西哥州大学医院确诊的汉他病毒感染的所有患者。干预措施：汉坦病毒感染的患者的记录进行了审查，收集所有相关的临床data. Measures和主要结果：在这些患者的肺部疾病的特点是低氧血症，涵盖了广泛的严重程度。低氧血症的原因是渗透性增加（非心源性）肺水肿，可通过其与低肺动脉闭塞压和水肿液蛋白含量增加的相关性与流体静力性（心源性）肺水肿相鉴别，严重病例的血液动力学测量显示以低心脏指数为特征的休克状态（范围1.6至3.0 L/min/m2）、低每搏输出量指数（范围10.5至29 mL/m2）和高全身血管阻力指数（范围1653至2997 dyne . sec/cm（5）。m（2））。进展至死亡与心功能不全恶化无反应的治疗，并造成氧债和乳酸acidosis.Conclusions：两个主要的危及生命的病理生理变化，汉坦病毒肺综合征的增加渗透性肺水肿，和一个非典型的形式，败血性休克引起的心肌抑郁症和低血容量。
Objective: To describe the clinical characteristics of a group of patients infected with the newly recognized hantavirus in the Southwestern United States.Design: Case series.Setting: Tertiary referral center.Patients: All patients with confirmed hantavirus infection admitted to the University of New Mexico Hospital between May 1, 1993 and January 1, 1994.Interventions: Records of patients with hantavirus infection were reviewed to collect all pertinent clinical data.Measurements and Main Results: Pulmonary disease in these patients was characterized by hypoxemia covering a wide range of severity. The cause of hypoxemia was an increased permeability (noncardiac) pulmonary edema which could be differentiated from hydrostatic (cardiac) pulmonary edema by its association with low pulmonary artery occlusion pressures and increased protein content of edema fluid, Hemodynamic measurements in severe cases showed a shock state characterized by a low cardiac index (range 1.6 to 3.0 L/min/m(2)), a low stroke volume index (range 10.5 to 29 mL/m(2)), and high systemic vascular resistance index (range 1653 to 2997 dyne . sec/cm(5) . m(2)). Progression to death was associated with worsening cardiac dysfunction unresponsive to treatment and causing oxygen debt and lactic acidosis.Conclusions: The two major life threatening pathophysiologic changes in Hantavirus Pulmonary Syndrome are increased permeability pulmonary edema, and an atypical form of septic shock caused by myocardial depression and hypovolemia.