Treatment of cor pulmonale and heart disease

Pulmonary heart and encephalopathy, also known as pulmonary heart and cerebrovascular syndrome, is caused by chronic bronchitis leading to emphysema and cor pulmonale, which can indirectly cause damage to brain tissue and lead to cerebral circulation disorders. More severe cases can cause patients to have impaired consciousness and cause other neurological and mental disorders. At this time, timely treatment is necessary, including treatment to remove the inducement, etc.

Treatment of cor pulmonale and heart disease

1. Conventional treatment:

1. Early diagnosis and early treatment: Once patients with cor pulmonale or serious underlying diseases develop impaired consciousness, increased blood carbon dioxide partial pressure, and decreased pH, measures should be taken as soon as possible to reduce the incidence of pulmonary encephalopathy.

2. Comprehensive treatment includes reasonable oxygen therapy, maintaining airway patency, improving ventilation function, and providing mechanical ventilation when necessary. Effectively control respiratory infections by administering respiratory stimulants, bronchodilators, diuretics, dehydration drugs, etc. The key measure is to correct CO2 retention and respiratory acidosis and protect the central nervous system function.

3. Respiratory monitoring: Send the patient to the respiratory monitoring unit for rigorous functional testing and timely treatment of complications to reduce mortality.

Specific treatment methods are as follows:

(1) Eliminate the cause: mainly to prevent the recurrence of lung infection. Remember not to use sleeping pills and sedatives (mainly for patients with type II respiratory failure) and do not inhale high-concentration oxygen.

(2) Actively improve ventilation: Correcting hypoxia and CO2 retention is a key measure to rescue pulmonary encephalopathy. The method has been mentioned above. When conventional treatment is ineffective, endotracheal intubation or tracheotomy should be performed decisively, and mechanical ventilation should be given to ensure the discharge of CO2 and the correction of hypoxia.

(3) Use of respiratory stimulants: The use of respiratory stimulants in the early stages of pulmonary encephalopathy has a better effect. See Treatment of Respiratory Failure for methods.

(4) Use of adrenal cortical hormones: The principle is high-dose, short-term therapy. Cordisone succinate 400-800 mg/d or dexamethasone 20-40 mg/d, intravenous administration. The course of treatment is 3 to 5 days.

(5) Dehydration therapy: Hypoxia and carbon dioxide retention can cause severe edema of brain cells and brain interstitium, and even worse, brain herniation can occur. Dehydration should be actively carried out, but dehydration often leads to blood concentration, makes sputum difficult to expel, promotes microthrombosis and aggravates respiratory and circulatory failure, so mild or moderate dehydration is often advocated. And give sufficient amount of colloidal solution to promote the reabsorption of cells and extracellular fluid into blood vessels, which is beneficial to the discharge of fluid.

(6) Correction of acid-base imbalance and electrolyte disturbance: Correction of acid-base imbalance and electrolyte disturbance in the diagnosis and treatment of pulmonary encephalopathy. Treatment should be targeted at several common types of acid-base imbalance.