補助循環の極意教えます

出版社： 中外医学社
著者：
発行日： 2018-08-10
分野： 臨床医学：内科  >  循環器一般
ISBN： 9784498134348
電子書籍版： 2018-08-10 （1版2刷）
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循環器救急においてとくに重要な手技のひとつである“補助循環管理”は、著者の前著『循環器救急の真髄 教えます』のなかでも、とくに好評だったテーマ。そこで本書は第2弾として補助循環の管理にテーマを絞り、著者が国立循環器病研究センター勤務時代に培った経験をベースに執筆。数少ないエビデンスの冷静な分析と病態生理に基づいた血行動態の評価を踏まえ、明日からのアクションにどう生かせばよいかを丁寧にわかりやすく解説。

目次

  • 第1話　ようこそ，補助循環の世界へ
    　　1　重症患者でもやっぱり病歴・身体所見
    　　2　ショックは必ずしも低血圧とは限らない
    　　3　血液ガス分析と暮らす
    　　4　補助循環を一直線上に並べるな
    　　5　エビデンスの向こう側へ補助循環を駆使しハートチームを牽引せよ

    第2話　補助循環管理のルーティン
    　　1　初期診療のルーティン：ABCD＋E3
    　　2　肺動脈カテーテルは死なない
    　　3　肺動脈カテーテルは悪くない．要は使い方
    　　4　肺動脈カテーテル指標を意識して心エコーをする
    　　5　肺動脈楔入圧vs左室流入血流速度波形
    　　6　1回拍出量vs左室流出路速度時間積分値
    　　7　［手技実践！］　肺動脈カテーテルを留置する
    　　8　肺動脈カテーテル指標の計測は呼吸相に注意

    第3話　IABPを知る
    　　1　IABPの原理は2つ
    　　2　IABPの駆動タイミングを調整する
    　　3　IABPはノーエビデンス？
    　　4　ハイリスクPCIでのIABPのエビデンス
    　　5　ガイドラインでのIABPの位置づけ
    　　6　ST上昇型心筋梗塞＋心原性ショックのワークアップ
    　　7　強心薬と昇圧薬（血管収縮薬）は全然違う！
    　　8　実臨床でのIABPの適応を考える
    　　9　IABPが禁忌となる場合
    　　10　［手技実践！］　IABPを挿入する
    　　11　IABP管理のやりかた
    　　12　IABP管理中の合併症・トラブル
    　　13　IABPの理にかなった離脱

    第4話　IABPの導入：NSTEMI　
    症例実況中継　1
    　　1　急性冠症候群と安定型冠動脈疾患の区別は“アート”　
    　　2　急性冠症候群の分類は心電図！　
    　　3　急性冠症候群の3つの病態　
    　　4　非ST上昇型急性冠症候群のキーワードは“リスク層別”　
    　　5　非ST上昇型急性冠症候群の血行再建術のタイミング　
    　　6　冠動脈バイパス術vs PCI　

    第5話　IABPの管理：致死性不整脈とポンプ不全
    症例実況中継　2
    　　1　致死性不整脈でフリーズしないために
    　　2　Regular wide QRS tachycardiaを鑑別する
    　　3　Regular wide QRS tachycardiaを鑑別する：アデノシン編
    　　4　Regular wide QRS tachycardiaを停止させる
    　　5　多形性VTをみたらQT時間と虚血をチェック！

    第6話　IABPの離脱：STEMI
    症例実況中継　3
    　　1　STEMIはとにかくカテ！
    　　2　STEMIの心電図診断が難しい病態を知っておく
    　　3　aVR誘導にも注目せよ
    　　4　さようならDoor-to-balloon．舞台はプレホスピタルへ
    　　5　Primary PCIの適応：アップデート2017
    　　6　STEMIの非梗塞責任血管へのPCIの是非
    　　7　心原性ショックを合併した多枝病変患者のprimary PCI
    　　8　混合静脈血酸素飽和度を使いこなす

    第7話　PCPSを知る
    　　1　PCPSの原理を知る
    　　2　PCPSと人工心肺を比較してみる
    　　3　PCPSにエビデンスはあるのか？
    　　4　PCPSのエビデンス：院内心停止（IHCA）編
    　　5　PCPSのエビデンス：院外心停止（OHCA）編
    　　6　ガイドラインでのPCPSの位置づけ
    　　7　PCPSの予後指標：SAVEスコア
    　　8　実臨床でPCPSの適応をどのように考えるか
    　　9　［手技実践！］PCPSの導入
    　　10　下肢虚血予防のための工夫
    　　11　心停止患者のPCPS駆動時に注意すること
    　　12　心停止患者に対する5つの脳保護戦略
    　　13　脳保護を意識した体温管理
    　　14　PCPSで行う体温管理
    　　15　PCPSの“呼吸”の管理
    　　16　PCPS管理のやりかた
    　　17　PCPS管理中の心機能回復を評価する：右橈骨動脈のPaO▼2▼
    　　18　PCPS管理中の心機能回復を評価する：ETCO▼2▼
    　　19　PCPS管理中の心機能回復を評価する：SvO▼2▼
    　　20　PCPS管理中の心機能回復を評価する：心係数
    　　21　PCPS管理中の心機能回復を評価する：左室駆出時間
    　　22　PCPS管理中の心機能回復を評価する：VTI
    　　23　PCPS管理中の心機能回復の評価が難しい病態
    　　24　PCPS管理中の適切なボリューム管理とは
    　　25　PCPS管理中に強心薬は必要？
    　　26　PCPS管理中に血管拡張薬は必要？
    　　27　PCPS管理中に人工呼吸器・IABPは必須？
    　　28　PCPSの合併症・トラブル
    　　29　PCPSの離脱：ウィーニング（国循編）
    　　30　PCPSの離脱：ウィーニング（海外編）
    　　31　PCPSの離脱：抜去
    　　32　自己心が回復したにもかかわらずPCPSが抜去できない時

    第8話　PCPSの導入：急性僧帽弁逆流
    　症例実況中継　4
    　　1　心雑音が聞こえない？　僧帽弁逆流
    　　2　僧帽弁の解剖と乳頭筋断裂について
    　　3　心雑音から疑う心室中隔穿孔

    第9話　PCPSの管理：劇症型心筋炎
    　症例実況中継　5
    　　1　心筋炎と心膜炎の区別
    　　2　心筋炎の診断に必ず心筋生検は必要か
    　　3　心筋炎の心電図
    　　4　免疫グロブリンとステロイド

    第10話　PCPSの離脱：IHCA
    　症例実況中継　6
    　　1　PCPSの離脱に重要なこころがけ

    第11話　VADを知る
    　　1　INTERMACSとは何か
    　　2　BTDBTBBTCBTTBTRDT
    　　3　VADの分類
    　　4　わが国で移植適応患者を登録する
    　　5　J-MACSでわが国の現状を知る
    　　6　体外設置型VADを知る
    　　7　VAD患者で右心に注目することの重要性
    　　8　VAD装着前に右心不全のリスクを評価する
    　　9　VAD前の臓器障害は可逆性？

    第12話　VADの導入：続・劇症型心筋炎
    症例実況中継　7（5の続き）
    　　1　実際のところ，BTRは可能なのか
    　　2　VADの離脱基準はあるのか

    第13話　Impellaを知る
    　　1　Impellaの特徴を知る
    　　2　左室を強力にアンローディングする
    　　3　［手技実践！］Impella 2.5を導入する
    　　4　Impella 2.5の管理
    　　5　Impella 2.5のトラブルと対処
    　　6　Impellaのエビデンス
    　　7　Detroit Cardiogenic Shock Initiative
    　　8　Impella 5.0で知っておくべきこと
    　　9　知っておきたいImpellaの欠点

    ◆INTERVIEW　◆お話相手　西連寺智子先生

この書籍の参考文献

参考文献のリンクは、リンク先の都合等により正しく表示されない場合がありますので、あらかじめご了承下さい。

本参考文献は電子書籍掲載内容を元にしております。

第2話 補助循環管理のルーティン

P.34 掲載の参考文献
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第3話 IABPを知る

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第4話 IABPの導入 : NSTEMI

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第5話 IABP の管理 : 致死性不整脈とポンプ不全

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第6話 IABPの離脱 : STEMI

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第7話 PCPSを知る

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第8話 PCPS の導入 : 急性僧帽弁逆流

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第9話 PCPS の管理 : 劇症型心筋炎

P.327 掲載の参考文献
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第11話 VADを知る

P.362 掲載の参考文献
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第12話 VADの導入 : 続・劇症型心筋炎

P.375 掲載の参考文献
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第13話 Impellaを知る

P.409 掲載の参考文献
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