{"id":5505,"date":"2026-03-10T16:15:58","date_gmt":"2026-03-10T09:15:58","guid":{"rendered":"https:\/\/ykhoataynguyen.com\/site\/?p=5505"},"modified":"2026-03-10T16:28:37","modified_gmt":"2026-03-10T09:28:37","slug":"su-dung-thuoc-van-mach-trong-cap-cuu-tim-mach-bs-pham-minh-tuan","status":"publish","type":"post","link":"https:\/\/ykhoataynguyen.com\/site\/su-dung-thuoc-van-mach-trong-cap-cuu-tim-mach-bs-pham-minh-tuan\/","title":{"rendered":"S\u1eed d\u1ee5ng thu\u1ed1c v\u1eadn m\u1ea1ch trong c\u1ea5p c\u1ee9u tim m\u1ea1ch &#8211; BS. Ph\u1ea1m Minh Tu\u1ea5n"},"content":{"rendered":"<p><strong>Nguy\u00ean l\u00fd s\u1eed d\u1ee5ng<\/strong><\/p>\n<ul class=\"gdAMzb\">\n<li><strong>M\u1ee5c \u0111\u00edch:<\/strong>\u00a0Ph\u1ee5c h\u1ed3i t\u01b0\u1edbi m\u00e1u m\u00f4 v\u00e0 c\u1ea3i thi\u1ec7n ph\u00e2n b\u1ed1 oxy cho c\u00e1c b\u1ec7nh nh\u00e2n trong t\u00ecnh tr\u1ea1ng s\u1ed1c.<\/li>\n<li><strong>Chi\u1ebfn l\u01b0\u1ee3c:<\/strong>\u00a0S\u1eed d\u1ee5ng li\u1ec1u thu\u1ed1c th\u1ea5p nh\u1ea5t c\u00f3 th\u1ec3 \u0111\u1ec3 duy tr\u00ec t\u01b0\u1edbi m\u00e1u m\u00e0 v\u1eabn h\u1ea1n ch\u1ebf bi\u1ebfn ch\u1ee9ng.\u00a0Vi\u1ec7c k\u1ebft h\u1ee3p c\u00e1c thu\u1ed1c li\u1ec1u trung b\u00ecnh th\u01b0\u1eddng mang l\u1ea1i hi\u1ec7u qu\u1ea3 huy\u1ebft \u0111\u1ed9ng t\u1ed1t h\u01a1n v\u00e0 \u00edt t\u00e1c d\u1ee5ng ph\u1ee5 h\u01a1n so v\u1edbi vi\u1ec7c t\u0103ng li\u1ec1u t\u1ed1i \u0111a m\u1ed9t lo\u1ea1i thu\u1ed1c ri\u00eang l\u1ebb.<\/li>\n<\/ul>\n<p><strong>C\u00e1c nh\u00f3m thu\u1ed1c ch\u00ednh<\/strong><\/p>\n<ul class=\"gdAMzb\">\n<li><strong>Catecholamines:<\/strong> T\u00e1c \u0111\u1ed9ng th\u00f4ng qua c\u00e1c th\u1ee5 th\u1ec3 alpha1, beta1, beta2 v\u00e0 dopaminergic.\n<ul class=\"gdAMzb\">\n<li><strong>Dopamine:<\/strong>\u00a0T\u00e1c d\u1ee5ng ph\u1ee5 thu\u1ed9c li\u1ec1u: li\u1ec1u th\u1ea5p k\u00edch th\u00edch receptor D1, D2 g\u00e2y gi\u00e3n m\u1ea1ch th\u1eadn; li\u1ec1u trung b\u00ecnh t\u0103ng co b\u00f3p c\u01a1 tim; li\u1ec1u cao g\u00e2y co m\u1ea1ch.<\/li>\n<li><strong>Dobutamine:<\/strong> C\u00f3 \u00e1i l\u1ef1c m\u1ea1nh v\u1edbi beta1 v\u00e0 beta2, gi\u00fap t\u0103ng cung l\u01b0\u1ee3ng tim v\u00e0 co b\u00f3p c\u01a1 tim.<\/li>\n<li><strong>Norepinephrine:<\/strong>\u00a0G\u00e2y co m\u1ea1ch m\u1ea1nh, \u00edt t\u00e1c \u0111\u1ed9ng \u0111\u1ebfn cung l\u01b0\u1ee3ng tim; l\u00e0 l\u1ef1a ch\u1ecdn \u01b0u ti\u00ean khi huy\u1ebft \u00e1p r\u1ea5t th\u1ea5p.<\/li>\n<li><strong>Epinephrine:<\/strong>\u00a0Ch\u1ec9 \u0111\u1ecbnh trong s\u1ed1c tim, ng\u1eebng tim v\u00e0 nh\u1ecbp ch\u1eadm kh\u00f4ng \u0111\u00e1p \u1ee9ng v\u1edbi atropine.<\/li>\n<\/ul>\n<\/li>\n<li><strong>Vasopressin:<\/strong>\u00a0C\u00f3 hi\u1ec7u qu\u1ea3 trong tr\u01b0\u1eddng h\u1ee3p s\u1ed1c kh\u00e1ng Norepinephrine ho\u1eb7c trong c\u1ea5p c\u1ee9u ng\u1eebng tim \u0111\u1ec3 c\u1ea3i thi\u1ec7n t\u01b0\u1edbi m\u00e1u n\u00e3o v\u00e0 c\u01a1 tim.<\/li>\n<li><strong>Nitroglycerin:<\/strong>\u00a0Thu\u1ed1c gi\u00e3n t\u0129nh m\u1ea1ch v\u00e0 \u0111\u1ed9ng m\u1ea1ch, \u0111\u1eb7c bi\u1ec7t h\u1eefu \u00edch trong ph\u00f9 ph\u1ed5i c\u1ea5p v\u00e0 suy tim c\u1ea5p.<\/li>\n<\/ul>\n<p><strong>\u1ee8ng d\u1ee5ng l\u00e2m s\u00e0ng<\/strong><\/p>\n<ul class=\"gdAMzb\">\n<li><strong>S\u1ed1c tim:<\/strong>\u00a0S\u1eed d\u1ee5ng Dobutamine ho\u1eb7c Dopamine khi huy\u1ebft \u00e1p t\u00e2m thu 70\u2013100 mmHg; k\u1ebft h\u1ee3p Norepinephrine khi huy\u1ebft \u00e1p &lt; 70 mmHg.<\/li>\n<li><strong>Suy tim c\u1ea5p:<\/strong>\u00a0Ch\u1ec9 d\u00f9ng thu\u1ed1c t\u0103ng co b\u00f3p khi c\u00f3 t\u1ee5t huy\u1ebft \u00e1p ho\u1eb7c d\u1ea5u hi\u1ec7u gi\u1ea3m t\u01b0\u1edbi m\u00e1u m\u00f4.<\/li>\n<li><strong>Ng\u1eebng tim:<\/strong>\u00a0Epinephrine gi\u00fap ph\u1ee5c h\u1ed3i co b\u00f3p c\u01a1 tim, trong khi Vasopressin h\u1ed7 tr\u1ee3 c\u1ea3i thi\u1ec7n t\u1ef7 l\u1ec7 t\u1eed vong ng\u1eafn h\u1ea1n.<\/li>\n<\/ul>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-5506 size-full\" src=\"https:\/\/ykhoataynguyen.com\/site\/wp-content\/uploads\/2026\/03\/Screenshot-2026-03-10-161429.png\" alt=\"\" width=\"964\" height=\"711\" title=\"\" srcset=\"https:\/\/ykhoataynguyen.com\/site\/wp-content\/uploads\/2026\/03\/Screenshot-2026-03-10-161429.png 964w, https:\/\/ykhoataynguyen.com\/site\/wp-content\/uploads\/2026\/03\/Screenshot-2026-03-10-161429-300x221.png 300w, https:\/\/ykhoataynguyen.com\/site\/wp-content\/uploads\/2026\/03\/Screenshot-2026-03-10-161429-768x566.png 768w\" sizes=\"auto, (max-width: 964px) 100vw, 964px\" \/><\/p>\n<p>Link: <a href=\"https:\/\/drive.google.com\/drive\/folders\/1eOOiGz7rwiLjROvfFpRv1GCkmAspKfnD\" rel=\"noopener\">https:\/\/drive.google.com\/drive\/folders\/1eOOiGz7rwiLjROvfFpRv1GCkmAspKfnD<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Nguy\u00ean l\u00fd s\u1eed d\u1ee5ng M\u1ee5c \u0111\u00edch:\u00a0Ph\u1ee5c h\u1ed3i t\u01b0\u1edbi m\u00e1u m\u00f4 v\u00e0 c\u1ea3i thi\u1ec7n ph\u00e2n b\u1ed1 oxy cho c\u00e1c b\u1ec7nh nh\u00e2n trong t\u00ecnh tr\u1ea1ng s\u1ed1c. Chi\u1ebfn l\u01b0\u1ee3c:\u00a0S\u1eed d\u1ee5ng li\u1ec1u thu\u1ed1c th\u1ea5p nh\u1ea5t c\u00f3 th\u1ec3 \u0111\u1ec3 duy tr\u00ec t\u01b0\u1edbi m\u00e1u m\u00e0 v\u1eabn h\u1ea1n ch\u1ebf bi\u1ebfn ch\u1ee9ng.\u00a0Vi\u1ec7c k\u1ebft h\u1ee3p c\u00e1c thu\u1ed1c li\u1ec1u trung b\u00ecnh th\u01b0\u1eddng mang l\u1ea1i hi\u1ec7u &hellip;<\/p>\n","protected":false},"author":23,"featured_media":5506,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[54],"tags":[],"class_list":["post-5505","post","type-post","status-publish","format-standard","has-post-thumbnail","","category-noi-tim-mach"],"_links":{"self":[{"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/posts\/5505","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/users\/23"}],"replies":[{"embeddable":true,"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/comments?post=5505"}],"version-history":[{"count":1,"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/posts\/5505\/revisions"}],"predecessor-version":[{"id":5507,"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/posts\/5505\/revisions\/5507"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/media\/5506"}],"wp:attachment":[{"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/media?parent=5505"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/categories?post=5505"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/tags?post=5505"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}