Kardiogenetik shok: Versiyalar orasidagi farq

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„Cardiogenic shock“ sahifasi tarjima qilib yaratildi
(Farq yoʻq)

4-Avgust 2022, 07:06 dagi koʻrinishi

Kardiogenik shok ( CS ) - yurak qorinchalarining disfunktsiyasi tufayli qon oqimining etarli emasligi natijasida yuzaga keladigan tibbiy favqulodda holat[1][2][3]. Noto'g'ri qon oqimining belgilari past siydik ishlab chiqarish (<30 ml / soat), sovuq qo'llar va oyoqlar va ong darajasining o'zgarishini o'z ichiga oladi. Shuning uchun odamlarda qon bosimi va yurak urishi keskin past bo'lishi mumkin.

Kardiogenetik shok kardiomiopatik, aritmik va mexanik omillarni o'z ichiga oladi. CS ko'pincha o'tkir miokard infarkti hisobiga kuchayishi mumkin[4]. Odamlarda ushbu shokning kombinatsiyalangan turlari bo'lishi mumkin.

Kardiogen shokni davolash tanadagi qon oqimini yaxshilash uchun dastlabki maqsadlarga ega bo'lgan sababga bog'liq. Buni bir necha usullar bilan amalga oshirish mumkin - suyuqlikni reanimatsiya qilish, qon quyish, vazopressorlar va ionotroplar. Agar kardiogen shok yurak xurujidan kelib chiqsa , yurak tomirlarini ochishga urinishlar yordam berishi mumkin. Aorta ichidagi ballon nasosi yoki chap qorincha yordami qurilmasi buni amalga oshirmaguncha vaziyatni yaxshilashi mumkin. Yurakning qisqarish qobiliyatini yaxshilaydigan dorilar (musbat inotroplar) yordam berishi mumkin; ammo, qaysi biri yaxshiroq ekanligi noma'lum va hozirgi vaqtda gemodinamik jihatdan beqaror bemorlarda o'limni kamaytirish uchun inotrop yoki vazodilatatsion terapiyani qo'llab-quvvatlovchi ishonchli dalillar yo'q[5]. Agar qon bosimi juda past bo'lsa, norepinefrin yaxshiroq bo'lishi mumkin, dopamin yoki dobutamin esa biroz past bo'lsa foydaliroq bo'lishi mumkin[6]. Kardiogen shok - bu erta tashxis bilan ham to'liq bartaraf etish qiyin bo'lgan holat. Shu bilan birga, mexanik qon aylanishini qo'llab-quvvatlashni erta boshlash, teri orqali erta koronar aralashuv, inotroplar va yurak transplantatsiyasi natijalarni yaxshilashi mumkin[7][8][9][10][11]. Diqqat disfunktsiyali organlarga qaratilgan (buyraklar uchun dializ, o'pka disfunktsiyasi uchun mexanik ventilyatsiya)[12].

Manbalar

  1. ↑ Rippe, James M.. Irwin and Rippe's intensive care medicine. Philadelphia: Lippincott Williams & Wilkins, 2003. ISBN 978-0-7817-3548-3. OCLC 53868338. 
  2. ↑ Marino, Paul L.. The ICU book. Baltimore: Williams & Wilkins, 1998. ISBN 978-0-683-05565-8. OCLC 300112092. 
  3. ↑ Society of Critical Care Medicine.. Fundamental Critical Care Support. Society of Critical Care Medicine, 2001. ISBN 978-0-936145-02-0. OCLC 48632566. 
  4. ↑ „UpToDate“.
  5. ↑ Uhlig, Konstantin; Efremov, Ljupcho; Tongers, Jörn; Frantz, Stefan; Mikolajczyk, Rafael; Sedding, Daniel; Schumann, Julia (November 5, 2020). "Inotropic agents and vasodilator strategies for the treatment of cardiogenic shock or low cardiac output syndrome". The Cochrane Database of Systematic Reviews 2020 (11): CD009669. doi:10.1002/14651858.CD009669.pub4. ISSN 1469-493X. PMID 33152122. PMC 8094388. //www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=8094388. 
  6. ↑ Kanter, Joe; Deblieux, Peter (2014). "Pressors and Inotropes". Emergency Medicine Clinics of North America 32 (4): 823–34. doi:10.1016/j.emc.2014.07.006. PMID 25441037. 
  7. ↑ Kataja, Anu; Tarvasmäki, Tuukka; Lassus, Johan; Cardoso, Jose; Mebazaa, Alexandre; Køber, Lars; Sionis, Alessandro; Spinar, Jindrich et al. (2017). "The association of admission blood glucose level with the clinical picture and prognosis in cardiogenic shock – Results from the Card Shock Study". International Journal of Cardiology 226: 48–52. doi:10.1016/j.ijcard.2016.10.033. PMID 27788389. 
  8. ↑ Basir, Mir B.; Schreiber, Theodore L.; Grines, Cindy L.; Dixon, Simon R.; Moses, Jeffrey W.; Maini, Brijeshwar S.; Khandelwal, Akshay K.; Ohman, E. Magnus et al. (2017). "Effect of Early Initiation of Mechanical Circulatory Support on Survival in Cardiogenic Shock". The American Journal of Cardiology 119 (6): 845–851. doi:10.1016/j.amjcard.2016.11.037. PMID 28040188. 
  9. ↑ Bagate, François; Lellouche, Nicolas; Lim, Pascal; Moutereau, Stephane; Razazi, Keyvan; Carteaux, Guillaume; De Prost, Nicolas; Dubois-Randé, Jean-Luc et al. (2017). "Prognostic Value of Relative Adrenal Insufficiency During Cardiogenic Shock". SHOCK 47 (1): 86–92. doi:10.1097/SHK.0000000000000710. PMID 27984534. 
  10. ↑ Vergara, Ruben; Valenti, Renato; Migliorini, Angela; Cerisano, Giampaolo; Carrabba, Nazario; Giurlani, Letizia; Antoniucci, David (2017). "A New Risk Score to Predict Long-Term Cardiac Mortality in Patients with Acute Myocardial Infarction Complicated by Cardiogenic Shock and Treated with Primary Percutaneous Intervention". The American Journal of Cardiology 119 (3): 351–354. doi:10.1016/j.amjcard.2016.10.034. PMID 27884422. 
  11. ↑ Sarswat, Nitasha; Hollenberg, Steven M. (2015). "Cardiogenic Shock". Hospital Practice 38 (1): 74–83. doi:10.3810/hp.2010.02.281. PMID 20469627. 
  12. ↑ Simko, Lynn Coletta; Culleiton, Alicia L. (July 2019). "Cardiogenic shock with resultant multiple organ dysfunction syndrome". Nursing Critical Care 14 (4): 26–33. doi:10.1097/01.CCN.0000565132.49413.54.  
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