摘要
目的观察米力农对合并低心排血量脓毒症患者的血流动力学的影响。方法2012年3月至2013年6月，北京医院外科ICU收治的合并低心排的脓毒症患者13例，予持续静脉输注米力农（O．25～O．50μg·kg^-1·min^-1），比较用药前以及用药后10min、2h、24h后PiCCO监测血流动力学参数的变化。结果用药10rain后的各项血流动力学参数如收缩压、舒张压、平均动脉压（MAP）、心率、中心静脉压（CVP）、全心舒张末容积指数（GEDI）、心指数（CI）、心功能指数（CFI）、每搏量指数（SVI）以及外周血管阻力指数（SVRI）与用药前相比均差异无统计学意义。维持用药2h及24h后患者CI（L·min^-1·m^-2）较用药前（2．7±0．6、2．9±0．5比2．3±0．6）（P〈0．001）、CFI（L／min）（3．6±0．8、3．9±0．8比3．1±0．9）（P=0．001）、SVI（ml／m^2）（28．6±10．3、28．8±9．9比25．3±9．1）（P=0．033）增高，SVRI（dyn·s·cm^-5·m^2）（2269．0±615．3、2094．0±542．2比2946．0±1417．o）（P=0．004）下降。结论对于合并低心排的脓毒症患者，低剂量维持泵人米力农，可增加心排量，降低体循环血管阻力。
Objective To study the hemodynamic effects of Milrinone in patients with sepsis and low cardiac output. Methods The study was conducted on 13 patients with sepsis and low cardiac output recruited at the surgical intensive care unit（SICU）of Beijing Hospital from March 2011 to June 2012. Continuous IV infusion of Milrinone was made at 0.25-0. 50μg·kg^-1·min^-1. Hemodynamic variables were monitored by PiCCO,and data at baseline, 10 min, 2 h,and 24 h after infusion were analyzed. Results No statistical differences were found between measurements at baseline and 10rain after milrinone infusion in variables such as systolic pressure, diastolic pressure, mean arterial pressure （MAP）, heart rate, central venous pressure （ CVP）, global end diastolic volume index （GEDI）, cardiac index（CI）, cardiac function index CFI）, stroke volume index（SVI）and systemic vessel resistance index （SVRI）.Increased CI（2.73±10.62,2.93±0.49 vs. 2. 33±0. 57 ） , CFI （ 3. 59±0. 84, 3. 85±0. 84 vs. 3. 12±0.93）and SVI（28.62±10.32,28.77±9.85 vs. 25.31±9.09）and decreased SVRt（2 269± 615.3,2 094 ±542.2 vs. 2 946±1 417.0） were observed at 2 h and 24 h after Milrinone infusion, compared with baseline data. Conclusions Continuous IV infusion of low dose milrinone can increase cardiac output and decrease systemic vascular resistance in patients with sepsis and low cardiac output.
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2016年第11期1172-1174,共3页
Chinese Journal of Geriatrics
