— 生理適應 · HARD · MCQ —
護理師照顧一位敗血性休克早期的病人，下列哪項血流動力學數值最可能出現？
A nurse is caring for a client with early-stage septic shock. Which hemodynamic finding is most likely?
- ADecreased cardiac output心輸出量減少
- BIncreased systemic vascular resistance全身血管阻力增加
- CDecreased central venous pressure中心靜脈壓降低
- DIncreased cardiac output✓ 正解心輸出量增加
— Explanation · 中文詳解 —
敗血性休克（Septic shock）早期（溫暖期）的血流動力學特徵是由於全身發炎反應引起周邊微血管廣泛擴張，導致系統血管阻力（SVR）顯著下降。為了維持重要的器官灌流，心臟會透過代償機制增加心搏出量（Cardiac output, CO）與心跳速率，此時病人皮膚呈現溫暖、潮紅。隨著病情惡化進入晚期，心肌功能受損，CO 才會下降。
The hemodynamic hallmark of early (warm) septic shock is widespread peripheral capillary vasodilation due to systemic inflammatory response, leading to a marked decrease in systemic vascular resistance (SVR). To maintain perfusion of vital organs, the heart compensates by increasing cardiac output (CO) and heart rate; the skin appears warm and flushed at this stage. As the disease progresses to the late stage with myocardial dysfunction, CO subsequently decreases.