Hemodynamic characteristics and early warnings in very old patients

Abstract

The hemodynamic characteristics of very old patients (VOPs) are unique. With increasing age, patients may experience reduced diastolic function, increased rates of valvular heart disease and coronary atherosclerosis, stiffer vessels, and a reduced heart response to stimulations. Structural and functional modifications are linked to cardiac aging; echocardiography reveals concentric remodeling of the left ventricle, dilation of the left atrium, thickening and calcification of the valves, modification of the large vessels, and abnormal ventricular relaxation. According to a comprehensive understanding of the insufficient compensatory mechanisms of the aging heart, arrythmia should be avoided to the maximum extent and "conservative" fluid therapy should be provided together with appropriate blood pressure control. Considering these factors will improve the success rate of resuscitation and significantly reduce economic loss. In addition, more attention should be paid to the diastolic blood pressure in VOPs.

Keywords: Hemodynamic; early warning; fluid therapy; resuscitation; very old patients.