在β阻塞剂和通道阻塞剂过量中为VA-ECMO进行设施间转移:两起案件的报告
Richard Fisher1, Santiago Batista Minaya2, Heather Brunette1
1Northwell Health, Department of Emergency Medicine, New Hyde Park, New York.
Clinical practice and cases in emergency medicine
|February 4, 2025
概括
静脉外体膜氧化 (VA-ECMO) 可以在严重的通道阻断剂和β阻断剂过量时拯救生命. 简化医院间转移与多学科合作改善了这些关键患者的治疗结果.
科学领域:
- 心脏病学 心脏病学
- 医学毒理学医学毒理学
- 关键护理医学 关键护理医学
背景情况:
- 过量服用通道阻塞剂 (CCB) 和β阻塞剂 (BB) 会导致危及生命的血管和心脏性休克.
- 标准治疗包括血管压缩剂,,葡萄糖和高剂量胰岛素高血糖治疗.
- 严重的病例可能需要静脉外体膜氧化 (VA-ECMO),往往需要跨设施转移.
研究的目的:
- 描述使用VA-ECMO对耐火性CCB/BB过量剂量患者进行的两次成功的设施间转移.
- 突出及时干预和协作护理在管理这些复杂过量药物的关键作用.
主要方法:
- 介绍了两例重度CCB/BB过量患者的病例报告,需要VA-ECMO.
- 案例1:一名56岁的男性服用过量安洛迪平,并被提前转移到VA-ECMO.
- 案例2: 一名19岁的女性过量服用普拉诺洛尔,通过直接转移获得了即时的VA-ECMO.
主要成果:
- 两位患者在医院间转移后都成功接受了VA-ECMO.
- 病例1患者在60天后在神经学上完好无损地出院.
- 案例2患者在九天后从精神病院出院.
结论:
- VA-ECMO是一种救命干预,用于CCB和BB过量服用的耐火性休克.
- 在中毒患者中为VA-ECMO进行设施间转移具有挑战性,并可能延迟护理.
- 精简的转移协议和多学科合作对于优化结果至关重要.
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