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老年创伤患者心脏挫伤所致心源性休克的主动脉内球囊反搏治疗

Intra-aortic balloon counterpulsation for cardiogenic shock due to cardiac contusion in an elderly trauma patient.

作者信息

Penney D J, Bannon P G, Parr M J A

机构信息

Intensive Care Medicine, Liverpool Hospital, Sydney, NSW, Australia.

出版信息

Resuscitation. 2002 Dec;55(3):337-40. doi: 10.1016/s0300-9572(02)00234-4.

Abstract

Blunt thoracic trauma may cause cardiac contusion and cardiogenic shock resistant to inotropic support. The use of intra-aortic balloon counterpulsation (IABCP) as a mechanical means of augmenting cardiac function following cardiac contusion is rare with case reports largely limited to its use in young trauma patients. We describe the case of a frail, 80-year-old woman who suffered cardiac contusion in a motor vehicle crash. She developed cardiogenic shock with electrocardiograph changes, elevated troponin T and severe global dysfunction on echocardiography. She was successfully managed with invasive monitoring, inotropic support and IABCP. This case provides support for aggressive resuscitation even in the very elderly as recovery from severe cardiac contusion may be possible.

摘要

钝性胸部创伤可能导致心脏挫伤和对强心支持无反应的心源性休克。主动脉内球囊反搏(IABCP)作为心脏挫伤后增强心脏功能的一种机械手段,其应用很少见,病例报告主要局限于其在年轻创伤患者中的使用。我们描述了一名80岁体弱女性在机动车碰撞事故中发生心脏挫伤的病例。她出现了心源性休克,伴有心电图改变、肌钙蛋白T升高以及超声心动图显示的严重全心功能障碍。通过有创监测、强心支持和IABCP,她得到了成功救治。该病例为即使是高龄患者进行积极复苏提供了支持,因为严重心脏挫伤有可能恢复。

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