COVID-19 and haemodynamic failure: a point of view on mechanisms and treatment

被引：5

作者：

Jasinski, Tomasz ^{[1
]}

Stefaniak, Jan ^{[1
]}

机构：

[1] Med Univ Gdansk, Dept Anaesthesiol & Intens Therapy, 17 Smoluchowskiego St, PL-80214 Gdansk, Poland

来源：

ANAESTHESIOLOGY INTENSIVE THERAPY | 2020年 / 52卷 / 05期

关键词：

hemodynamics; COVID-19; critical care; SARS-CoV-2; cardiovascular; HYPOXIC PULMONARY VASOCONSTRICTION; ACUTE KIDNEY INJURY; NEW-YORK-CITY; SEPTIC SHOCK; ANGIOTENSIN-II; SEVERE SEPSIS; SYSTEMIC INFLAMMATION; MORTALITY; MANAGEMENT; OUTCOMES;

D O I：

10.5114/ait.2020.101813

中图分类号：

R614 [麻醉学];

学科分类号：

100217 ;

摘要：

The SARS-CoV-2-related disease has an undoubted impact on the healthcare system. In the treatment of severe COVID-19 cases, the main focus is on respiratory failure. However, available data suggest an important contribution of haemodynamic impairment in the course of this disease. SARS-CoV-2 may affect the circulatory system in various ways that are universal for septic conditions. Nonetheless, unique features of this pathogen, e.g. direct insult leading to myocarditis and renin-angiotensin-aldosterone axis dysregulation, must be taken into account. Although current recommendations on COVID-19 resemble previous septic shock guidelines, special attention to haemodynamic monitoring and treatment is necessary. Regarding treatment, one must take into account the potential profound hypovolaemia of severe COVID-19 patients. Pharmacological cardiovascular support should follow existing guidelines and practice. Interesting concepts of decatecholaminisation and the effect of vasopressors on pulmonary circulation are also presented in this review on COVID-19-related haemodynamic failure.

引用

页码：409 / 417

页数：9

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