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PostSubject: improve contractile function   Fri Apr 06, 2007 5:18 pm

Typically, sodium nitroprusside and nitroglycerin use in acute heart failure, giving these drugs intravenous drip. When HSN their use in the event of an abrupt deterioration of HSN when other drugs are not allowed to withdraw from the case of a health (refrakternaya HSN). Most use izosorbitdinitrat (nitrosorbit) in the dose of 30-40 mg / day for 3-4 reception in combination with IAPF, cardiac glycosides, mochegonnami (vazodilatatora not drugs I stimulants in the treatment of HSN, they have only the support). When treating the products needed to be monitored for some haemodynamic rates to be determined by the direct and non-invasive methods (sensing right divisions heart, echocardiography, etc.). Minimum such indicators include central ORIONE pressure, arterial pressure, diastolicescoe pressure in the pulmonary artery heart index. Preparations have given effect to tone veins, reduce it and increase peripheral venous capacity, and hence limit the return of venous blood to the heart. Reduced diastolicescoe filling right divisions heart, and then pulmonary artery, accompanied by unloading the pulmonary circulation and reduced diastolic filling of the left heart chamber. These funds should be appointed sick overloading the pulmonary circulation and saved function left heart (eg, mitralnah evils without prevalence stenosis in ateroskleroticescom cardiosklerose). Preparations have given effect to tone arteriol reduce the total force on resistance and vnutriaortalinoe pressure. This leads to an increase in heart and the release of the white tissue. Mostly артериолярные вазодилататоры be applied with little overburdened small circle me low index and an adequate level of AD (eg, hypertension, lack аортального and / or mitral valve). Mixed vazodilatatora recommended for use in severe circulatory failure, overloading small circle me low index (eg, dilataih cardiomiopatiah, postinfarctne cardiosklerose, late stages insufficient aortalni or mitral valve). Peripheric vazodilatatora all groups protivopokazana patients have expressed mitralnam and / or aortalnam stenosis, as in these cases, reducing the flow of blood to the heart and a decrease in the total peripheral resistance in terms of the left chamber and the state of the patients. To improve contractile function of the heart using heart glycosides; Are assigned patients with HSN teams stage. Selecting the optimum гликозида heart for the treatment of a patient is an important task, and is based on a number of principles : 1. intravenous appointment glycosides (strofantin, digoxin, korglikon) should be limited to increasing HSN, which the impact must be obtained immediately; in other cases treated, it will be better to start with the admission of oral digoxin, or digitoksina izolanida; 2. in the highly advanced HSN and expressed changes digestive tract to be cures users, as the product inside poorly absorbed from the gastrointestinal tract and strengthens despepsiceskie phenomenon.

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