医学
右美托咪定
心动过速
胺碘酮
围手术期
室性心动过速
心脏病学
内科学
麻醉
房室结
心房颤动
镇静
作者
Kirsti Catton,Jennifer K. Peterson
出处
期刊:Critical Care Nurse
[AACN Publishing]
日期:2020-02-01
卷期号:40 (1): 46-55
被引量:2
摘要
Junctional ectopic tachycardia is a common dysrhythmia after congenital heart surgery that is associated with increased perioperative morbidity and mortality. Risk factors for development of junctional ectopic tachycardia include young age (neonatal and infant age groups); hypomagnesemia; higher-complexity surgical procedure, especially near the atrioventricular node or His bundle; and use of exogenous catecholamines such as dopamine and epinephrine. Critical care nurses play a vital role in early recognition of dysrhythmias after congenital heart surgery, assessment of hemodynamics affecting cardiac output, and monitoring the effects of antiarrhythmic therapy. This article reviews the underlying mechanisms of junctional ectopic tachycardia, incidence and risk factors, and treatment options. Currently, amiodarone is the pharmacological treatment of choice, with dexmedetomidine increasingly used because of its anti-arrhythmic properties and sedative effect.
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