案例报告:有效的体外心肺复苏在长期心脏骤停中
Wangjun Yan1, Guanxiu Tang2, Hui Wang1
1Department of Intensive Care Medicine, Hunan Aerospace Hospital, Changsha, China.
Frontiers in cardiovascular medicine
|November 13, 2025
概括
身体外心肺复苏 (ECPR) 为长期心脏骤停提供了一种救援策略. 这一案例表明,ECPR和高级重症监护甚至在经过长时间的复苏努力后也可以带来良好的结果.
科学领域:
- 心脏病学 心脏病学
- 关键护理医学 关键护理医学
- 紧急医疗 紧急医疗
背景情况:
- 心脏骤停带来高死亡率,常规心肺复苏 (CCPR) 后的结果很差.
- 使用静脉动脉外体膜氧化 (VA-ECMO) 的体外心肺复苏 (ECPR) 提供了对耐心性心脏骤停的心肺支持.
- 在长期心脏骤停的情况下,ECPR可以治疗潜在原因.
研究的目的:
- 为了说明ECPR在异常长期心脏骤停的情况下的潜力.
- 为突出成功的ECPR和VA-ECMO应用在因心肌梗塞而导致耐火性心脏骤停的患者.
- 强调及时ECPR和全面重症监护的重要性,以改善生存和神经结果.
主要方法:
- 一名44岁的男性因急性心肌梗塞而患有长期心脏骤停 (155分钟CPR),接受了ECPR和VA-ECMO治疗.
- 冠状动脉扫描揭示了严重的多血管疾病,在ECMO支持下,通过皮肤冠状动脉干预 (PCI) 进行治疗.
- 逮捕后的护理包括机械通风,有针对性的温度管理,内热/血管压缩剂支持,抗血栓治疗和神经保护.
主要成果:
- 只有在ECPR启动后才能成功恢复自发循环.
- 由于重症监护,该患者经历了一次大脑叶心脏病发作,但由于重症监护,神经功能保持完整.
- ECMO在第9天被奶,患者在第12天被抽管,使神经系统完全恢复.
结论:
- 极长时间的心脏骤停可以带来有利的结果,即时ECPR和全面的重症监护.
- 在耐心性心脏骤停中,ECPR显示了改善存活率和神经结果的显著潜力.
- 快速VA-ECMO部署对于经历耐心性心脏骤停的选定患者至关重要.
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