易布鲁丁尼布诱导的腹腔电风暴成功地通过静脉动脉ECMO和内脂剂的管理得到控制:一个罕见的病例报告
Debora E Torre1, Carla Stecco2, Andrea Porzionato2
1Department of Cardiac Anesthesia and Intensive Care Unit, Cardiac Surgery, Ospedale Dell'Angelo, Venice Mestre, Italy.
Annals of cardiac anaesthesia
|August 29, 2024
概括
用于B细胞淋巴瘤的易布鲁替尼可以导致严重的心脏事件,如心室失常风暴. 静脉动脉外体膜氧化成功治疗了一名患有这种情况的患者,使得化学疗法可以继续进行.
科学领域:
- 在瘤学瘤学.
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
背景情况:
- 中枢神经系统非霍奇金淋巴瘤B细胞 (LNH-PNSLC) 是一种罕见的恶性瘤.
- 易布鲁替尼是用于治疗某些B细胞淋巴瘤的向疗法.
- 心脏不良事件是与ibrutinib治疗相关的已知风险.
研究的目的:
- 报告在为LNH-PNSLC治疗ibrutinib后出现心室失常风暴的病例.
- 强调静脉动脉外体膜氧化 (VA-ECMO) 在管理因易布鲁丁尼布而导致危及生命的心脏事件中的关键作用.
- 为了强调对于易布鲁丁尼布诱导的心脏毒性缺乏特定的解药.
主要方法:
- 一名55岁的男性患者患有LNH-PNSLC,他接受了瑞图西马布,甲铁和易布鲁替尼.
- 患者在ibrutinib服用两小时后出现了耐火性心室失律风暴.
- 开始进行静脉动脉外体膜氧化,以提供血液动力学支持.
主要成果:
- 易布鲁替尼治疗导致了严重的心室电风暴和心脏骤停.
- VA-ECMO提供了拯救生命的循环支持,促进了患者的康复.
- 患者实现了完全的神经恢复,并能够恢复化疗.
结论:
- 易布鲁替尼可能与严重的,可能致命的心脏事件有关,包括心室心律失常风暴.
- 在没有抗毒剂的情况下,VA-ECMO是管理易布鲁替尼引起的心脏毒性的关键干预措施.
- 及时的VA-ECMO支持可以导致成功的患者救援和瘤治疗的延续.
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