在使用手术内自动化心肺复苏器进行心脏骤停后的完整生存
Ralph Frascone1, Thomas Blee2, David Dries2
1Regions Hospital, Department of EMS, St. Paul, MN, United States of America.
Trauma case reports
|August 21, 2023
概括
由于突发创伤性心脏骤停而成功的复苏是罕见的. 这一案例突出了自动心肺复苏与损伤控制腹腔切除术相结合的潜力,以改善某些腹内损伤患者的生存率.
科学领域:
- 紧急医疗 紧急医疗
- 创伤外科 手术 创伤外科
- 关键护理医学 关键护理医学
背景情况:
- 在历史上,突发创伤性心脏骤停 (BTCA) 的存活率非常低.
- 目前BTCA的指导方针通常涉及复苏性胸腔切除术,其失败率很高.
- 技术的进步,包括护理点超声波 (POCUS) 和自动心肺复苏器件,提供了新的复苏策略.
研究的目的:
- 报告BTCA患者使用自动心肺复苏装置和损伤控制腹腔切除术的首次成功复苏.
- 评估损伤控制腹腔切除术作为BTCA的初始手术方法的可行性,具有特定的POCUS发现.
- 建议在BTCA案件中使用自动化CPR的标准.
主要方法:
- 一名BTCA患者在探索性损伤控制腹腔切除术之前和期间使用自动化心肺复苏装置进行了复苏.
- 护理点超声波用于识别腹内损伤,排除不稳定的胸内损伤.
- 强烈的血液制品的管理是同时进行的.
主要成果:
- 患者,尽管严重的创伤,经历了成功的复苏.
- 患者在神经功能完好无损的情况下被送回家.
- 这一案例表明,在以前几乎致命的场景中,存在潜在的生存益处.
结论:
- 自动心肺复苏,结合损伤控制腹腔切除术,可能是选择BTCA患者的可行策略.
- POCUS对于指导BTCA手术方法至关重要,识别腹内出血,同时排除胸内紧急情况.
- 这种方法,加上积极的复苏,为改善BTCA的结果提供了一条新的途径.
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