Myocardial dysfunction during H1N1 influenza infection
Myocardial dysfunction during H1N1 influenza infection
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DOI：
10.1016/j.jcrc.2013.01.010
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发表时间：
2013-08-01
影响因子：
3.7
通讯作者：
De Backer, Daniel
中科院分区：
文献类型：
--
作者：
Fagnoul, David;Pasquier, Pierre;De Backer, Daniel
目的：探讨H1N1感染的危重病患者右室和左室功能障碍的发生率和血流动力学影响。在重症监护病房期间，每天记录血液动力学和呼吸情况。结果：46名患者入院时患有严重的H1N1感染。39例患者入院时行超声心动图检查：28例(72%)心功能异常，其中13例(46%)为单发左室功能异常，11例(39%)为单发右室功能不全，4例(14%)为双室功能不全。39例患者中有19例在住院期间复查超声心动图：右室功能有随时间延长而恶化的趋势，但左室功能趋于正常。脑室异常与病史、呼吸衰竭的严重程度或血流动力学状态无关。然而，心功能不全的患者需要更积极的治疗，包括更频繁地使用血管升压剂和变力药物，以及抢救性呼吸机策略，如吸入一氧化氮、俯卧位和体外膜氧合。结论：这些观察强调了H1N1流感感染患者心功能障碍的高发。(C)2013 Elsevier Inc.保留所有权利。
Purpose: The purpose of the study is to evaluate the incidence and hemodynamic consequences of right ventricular (RV) and left ventricular (LV) dysfunction in critically ill patients with H1N1 infection.Patients and methods: This is a retrospective analysis of all patients admitted to the intensive care unit of an academic hospital between October 2009 and March 2011 with severe H1N1 infection. Hemodynamic measurements and respiratory conditions were noted daily during the intensive care unit stay.Results: Forty-six patients were admitted with severe H1N1 infection. Echocardiography was obtained in 39 patients on admission: 28 (72%) had abnormal ventricular function, of whom 13 (46%) had isolated LV abnormalities, 11 (39%) had isolated RV dysfunction, and 4 (14%) had biventricular dysfunction. Echocardiography was repeated in 19 of the 39 patients during their hospitalization: RV function tended to worsen with time, but LV function tended to normalize. The ventricular abnormalities were not associated with history, severity of the respiratory failure, or hemodynamic status. However, patients with ventricular dysfunction needed more aggressive therapy, including more frequent use of vasopressor and inotropic agents and of rescue ventilatory strategies, such as inhaled nitric oxide, prone positioning, and extracorporeal membrane oxygenation.Conclusions: These observations emphasize the high incidence of cardiac dysfunction in patients with H1N1 influenza infections. (C) 2013 Elsevier Inc. All rights reserved.