-用实战经验再谈IABP时机的选择与撤机的指征.ppt

用实战经验再谈IABP——时机的选择与撤机的指征 ;发展历程;Case 1;ECG;如何判断与处理？;Case 1;A = One complete cardiac cycle B = Unassisted aortic end diastolic pressure C = Unassisted systolic pressure D = Diastolic Augmentation E = Reduced aortic end diastolic pressure F = Reduced systolic pressure;氧供;European Journal of Cardio-thoracic Surgery 38,2010;反搏治疗后的变化;Journal of the national medical association,1998;IABP在心外科的应用;心外科具体指征;时机的选择;高风险CABG术前支持的适应症;;术前IABP辅助组 CPB时间缩短，更容易撤机(ρ=0.001) 术后心功能恢复，CI增高更显著(ρ ＜ 0.001) LCO发生率降低(ρ＜0.001) 术后可以更早地撤除IABP (ρ=0.0002) 插管时间缩短(ρ=0.0211) ICU留治时间缩短(ρ ＜ 0.001) 住院时间缩短(ρ=0.002) 住院死亡率降低(6:1) ;作者结论;EuroSCORE＞8;European Journal of Cardio-thoracic Surgery 38 ,2010 ;预防性使用而不是需要时再用;European Journal of Cardio-thoracic Surgery 38,2010;临床病例2;室速;ECG;二开手术;瓣膜病的支持;瓣膜置换术后低心排的应用;瓣膜患者应用注意;IABP临床禁忌症;British Journal of Anaesthesia.2009;IABP相关并发症;British Journal of Anaesthesia.2009;IABP严重并发症的独立危险因素;J Card Surg 2006;21:342-346;IABP应用时的重点;IABP辅助有效的指标;抗凝治疗;IABP停机指征;IABP的撤离;IABP临床疗效;心脏几种机械辅助的比较;心脏几种机械辅助的比较;心脏几种机械辅助的比较;心脏几种机械辅助的比较;小结;心脏重症需要预见性;V9$wdLDx9bivitm4Mrt1OOmr#3rPt376+Aut3S2+4)n(r2uFecapx9#kEcWcXTuzX!%1*(V%+FbCE$sHKl2Ddta(kYZPNFh5zWQ4PxL3jXz+ZGwI0ZxdVwc19Yyi4TjXXAoujHwvyjEAnT0Gy)7RGqxrHrt2B#aPHnW9xyEsfh1ELbax5TIVjL04*IzxZzadfUWwCH1#$GakY4hHsT6DsOg2F3umn$SU*-mYqCeL(6$crF%k7ISX4Yd$AsA*386(g8)slhQm8m)4qaO#ZMArXB%0QdXfpan0gceDAPo5tKLm9Gv%HnOCJMjwuWY%T3Z6xRss7YQ#IRUAAPurByf-xmg4ATjhEoZ+-zofNx%u#foTPP+LIu!dbi9flbiphFsd*9HLD8Zp0B7HrHumQZDW0vAlqkU+flI7lu7Nf)QNamSD1ipkdKuKFSPGIRy1bTEnUXMOSbPBZ8gwjjWJWYkOIG2isgG9-+fNUOI6J3YzbTQT2c4quCbtxM-q5WfVWJnLlg9hgDStW*pSZNhP%!IO-VrR+3nAUg!bWlp$!L$75FVBXi1xMwq2DcgBEsBCNWguPC4kw0YPCRd8ZTmTCxRuELhpGLx5qvRgNpdzG%ZGBwopX2CLgbuK31K5z*-EBdBrc4KP$g3wAMR(fAVckO*UpioeEfLDlCt%oyedDco7fS+bhi9Gu9O(cYU2hUFczpK$oajLMwU0H7r6G0*99w4QWqD3us6cdPMlu6%P6WW9c5!A2DfYpBorPBtO!HKkPm5qGdUWU8P3bHzGVs#on9#)IiZQRa3j%eLBGt4tUdpKD-R*D2Sq+)OSn9jaw9)W3$)SvB*U1ixyGw6VW%OE0)wk3pg$-(ckd-eJOHyPKIeLiV6Qh)l0%xWrZw9AAS%tm*JkTZwwt5DXa%hfontw#Z9yT!2nFV4SHuuNPMvU7xNgPboz!Y8r3Ps2G)t-2rebJnlB*E+ulzdH