成功进行体外心肺复苏,尽管有大动脉封闭
Torben K Becker1, John Bruno1, Eric I Jeng2
1From the Division of Critical Care Medicine, Department of Emergency Medicine, College of Medicine, University of Florida, Gainesville, Florida.
概括
身体外心肺复苏 (ECPR) 可以通过手术血管移植成功启动,在患有全内大动脉封闭的患者中. 这种方法为患有复杂血管解剖的心脏骤停患者提供了一个可行的选择,使得拯救生命的干预成为可能.
科学领域:
- 心脏病学 心脏病学
- 心血管外科心血管外科
- 关键护理医学 关键护理医学
背景情况:
- 严重的冠状动脉疾病可能导致耐火性心室动,心脏骤停.
- 下大动脉的完全闭塞对循环支持来说是一个挑战.
- 现有的外科绕道移植可能会提供替代的输管路径.
研究的目的:
- 描述在患有严重冠状动脉疾病和全内动脉封闭的患者中成功启动体外心肺复苏 (ECPR) 的情况.
- 为了证明使用预先存在的外科手术血管移植用于ECPR管道的可行性.
- 要强调的是,通过绕道的大动脉封闭并不是体外膜氧化 (ECMO) 的绝对禁忌.
主要方法:
- 在患有耐火性心室动心脏骤停的患者中启动了ECPR.
- 对ECPR的注射器是通过双骨-骨外科移植进行的,使用骨动脉进行中央循环,并使用骨-骨移植进行左腿输液.
- 患者随后在ECMO支持下接受了冠状动脉旁路移植手术.
主要成果:
- 通过手术移植成功启动和维护ECPR.
- 患者在神经学上完好无损地被抽管,并从ECMO中断奶.
- 患者在神经学上完好无损,独立地回家.
结论:
- 通过手术血管移植对ECPR进行注射是可行的.
- 通过手术绕道进行的全内动脉封闭并不是ECMO的绝对禁忌.
- 通过手术移植进行ECPR可以为精选的心脏骤停患者提供拯救生命的选择.
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