๋„“์€ QRS ๋นˆ๋งฅ์—์„œ ์•„๋ฏธ์˜ค๋‹ค๋ก  / Amiodarone for wide-complex tachycardia

์ •์˜

Amiodarone์€ ์ง€์† ๋˜๋Š” ์žฌ๋ฐœํ•˜๋Š” ๋„“์€ QRS ๋นˆ๋งฅ/VT์—์„œ ์‚ฌ์šฉํ•  ์ˆ˜ ์žˆ๋Š” ํ•ญ๋ถ€์ •๋งฅ์ œ ์˜ต์…˜์ด๋‹ค. raw ์ž๋ฃŒ์—์„œ๋Š” stable wide-QRS VT ๋˜๋Š” refractory/recurrent VT ์ƒํ™ฉ์˜ ์•ฝ์ œ ์„ ํƒ์ง€๋กœ ์ œ์‹œ๋˜์—ˆ๋‹ค.

์ž„์ƒ ํ•ต์‹ฌ

๋งฅ๋ฐ• ์žˆ๋Š” regular monomorphic VT๊ฐ€ unstable์ด๋ฉด ์•ฝ์ œ๋ณด๋‹ค synchronized cardioversion์ด ์šฐ์„ ์ด๋‹ค. cardioversion ํ›„์—๋„ VT๊ฐ€ ์ง€์† ๋˜๋Š” ์žฌ๋ฐœํ•˜๋ฉด ์›์ธ ๊ต์ •๊ณผ ํ•จ๊ป˜ amiodarone์„ ๊ณ ๋ คํ•œ๋‹ค. ์ „๊ธฐ์น˜๋ฃŒ, ํ•ญ๋ถ€์ •๋งฅ์ œ, expert consultation์„ ๋ณ‘ํ–‰ํ•ด์•ผ ํ•œ๋‹ค.

์ง„๋‹จ

ํˆฌ์—ฌ ์ „ํ›„ rhythm, pulse, BP๋ฅผ ์žฌํ‰๊ฐ€ํ•œ๋‹ค. VT ์œ ๋ฐœ ์›์ธ์œผ๋กœ ischemia/ACS, ์ „ํ•ด์งˆ ์ด์ƒ, hypoxia, acidosis, drug toxicity, QT prolongation ๋“ฑ์„ ํ™•์ธํ•œ๋‹ค.

์น˜๋ฃŒ

์šฉ๋Ÿ‰: amiodarone 150 mg IV over 10 min, ํ•„์š” ์‹œ ๋ฐ˜๋ณตํ•œ๋‹ค. ์ดํ›„ 1 mg/min infusion์„ 6์‹œ๊ฐ„ ์œ ์ง€ํ•˜๋Š” ์ „๋žต์ด ์ œ์‹œ๋˜์—ˆ๋‹ค. polymorphic VT/torsades ์˜์‹ฌ ๋˜๋Š” ๋ฌด๋งฅ์„ฑ ์ „ํ™˜ ์‹œ์—๋Š” ํ•ด๋‹น ์•Œ๊ณ ๋ฆฌ์ฆ˜์— ๋งž์ถฐ defibrillation ๋ฐ Mg/K ๊ต์ •์„ ์šฐ์„ ํ•œ๋‹ค.

์ถœ์ฒ˜

AHA 2025 Adult Tachyarrhythmia With a Pulse Algorithm.

๐ŸŒฑ ์ถœ์ฒ˜ raw


๋ณธ ๋ฌธ์„œ๋Š” ํ•™์Šตยท์ฐธ๊ณ ์šฉ์ด๋ฉฐ ์‹ค์ œ ์ง„๋ฃŒ ๊ฒฐ์ •์€ ์ž„์ƒ์˜์˜ ํŒ๋‹จ์ž…๋‹ˆ๋‹ค.