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Anaesthesia in septic patients: good preparation and making the right choice?

机译:败血症患者的麻醉:做好准备并做出正确选择?

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摘要

Septic patients may require anaesthesia for surgery or to facilitate endotracheal intubation for respiratory failure. These patients frequently start with a deranged haemodynamic state, including vasodilation with hypotension, and cardiomyopathy, making induction of anaesthesia a potentially hazardous task. Anaesthetic agents are well known to decrease contractility and to cause vasodilation - in part from direct effect of the drugs, and in part due to the state of anaesthesia, that causes reduced sympathetic tone. Before induction, the physician should understand the haemodynamic state (especially using echocardiography), should restore cardiovascular reserve with inotropes and vasopressors, and should induce anaesthesia with the smallest dose of the safest drug. In the previous issue of Critical Care, Zausig and colleagues show that propofol may not be the safest choice of induction agent in septic patients.
机译:败血病患者可能需要进行手术麻醉或为了呼吸衰竭而进行气管插管。这些患者经常以血液动力学状态紊乱开始,包括伴有低血压的血管舒张和心肌病,使麻醉诱导成为潜在的危险任务。众所周知,麻醉剂会降低收缩力并引起血管舒张-部分是由于药物的直接作用,部分是由于麻醉状态导致交感神经张力降低。入院前,医师应了解血液动力学状态(尤其是使用超声心动图),应使用正性肌力药和血管升压药恢复心血管储备,并应以最小剂量的最安全药物进行麻醉。在上一期的《重症监护》中,Zausig及其同事表明,异丙酚可能不是败血症患者最安全的诱导剂选择。

著录项

  • 作者

    Royse, Colin F;

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  • 年度 2009
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  • 原文格式 PDF
  • 正文语种 {"code":"en","name":"English","id":9}
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