意外近缢伤后非心源性肺水肿

Noncardiogenic pulmonary edema following accidental near-hanging.

作者信息

Trujillo Maximo H, Fragachan Carlos F, Tortoledo Francisco

机构信息

Critical Care Unit of The Instituto Medico La Floresta, Caracas, DC, Venezuela.

出版信息

Heart Lung. 2007 Sep-Oct;36(5):364-6. doi: 10.1016/j.hrtlng.2006.10.005.

DOI:10.1016/j.hrtlng.2006.10.005

PMID:17845882

Abstract

A 79 year-old woman was admitted to our institution unconscious with pulmonary edema. She had been trapped by the neck in the electric sliding gate of her own home garage. A pulmonary artery catheter was inserted through the right internal jugular vein and her hemodynamic profile and chest x ray revealed a non cardiogenic pulmonary edema. Intensive care management consisted of assisted/controlled ventilatory support with low grade of PEEP (6 cm H2O) and loop diuretics. Three days later, the chest x-ray showed resolution of the pulmonary edema and she made a full recovery. Near-hanging due to neck compression can be a life-threatening cause of non-cardiogenic pulmonary edema, and should be included in the differential diagnosis of pulmonary edema.

摘要

一名79岁女性因肺水肿昏迷被送至我院。她在家中车库的电动滑门处被卡住颈部。通过右颈内静脉插入肺动脉导管，其血流动力学指标和胸部X光显示为非心源性肺水肿。重症监护管理包括采用低水平呼气末正压（6厘米水柱）的辅助/控制通气支持和袢利尿剂。三天后，胸部X光显示肺水肿消退，她完全康复。颈部受压导致的近乎窒息可能是危及生命的非心源性肺水肿的原因，应列入肺水肿的鉴别诊断范围。