患有哮喘持续状态儿童的蛛网膜下腔出血：允许性高碳酸血症的意义
Subarachnoid hemorrhage in a child with status asthmaticus: significance of permissive hypercapnia.
作者信息
Edmunds Suzanne M, Harrison Rick
机构信息
Department of Pediatric Critical Care, Our Lady of the Lake Regional Medical Center, Baton Rouge, LA, USA.
出版信息
Pediatr Crit Care Med. 2003 Jan;4(1):100-3. doi: 10.1097/00130478-200301000-00020.
OBJECTIVE
To report an 11-yr-old boy with acute status asthmaticus being managed with permissive hypercapnia who developed a subarachnoid hemorrhage during the course of his illness.
SETTING
An eight-bed pediatric intensive care unit in a community hospital.
INTERVENTIONS
The patient was intubated for respiratory failure and managed with permissive hypercapnia. After the development of changes in his pupillary exam, computerized tomography of the brain revealed diffuse subarachnoid hemorrhage. Carotid angiography was performed to rule out the possibility of underlying vascular malformation.
RESULTS
Aggressive investigation including a normal carotid angiogram failed to reveal underlying pathology that may have put the patient at risk for the event.
CONCLUSIONS
We conclude that this patient suffered subarachnoid hemorrhage in association with the use of permissive hypercapnia in the settling of severe asthma.
目的
报告一名11岁患有急性哮喘持续状态的男孩，在采用允许性高碳酸血症治疗期间发生了蛛网膜下腔出血。
背景
一家社区医院的八床位儿科重症监护病房。
干预措施
患者因呼吸衰竭插管，并采用允许性高碳酸血症治疗。在其瞳孔检查出现变化后，脑部计算机断层扫描显示弥漫性蛛网膜下腔出血。进行颈动脉血管造影以排除潜在血管畸形的可能性。
结果
包括正常颈动脉血管造影在内的积极检查未能发现可能使患者面临该事件风险的潜在病理情况。
结论
我们得出结论，该患者在严重哮喘的治疗过程中因使用允许性高碳酸血症而发生了蛛网膜下腔出血。
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