Marshall Scott A, Nyquist Paul
Department of Neurosciences Critical Care, The Johns Hopkins Hospital, Johns Hopkins University, Baltimore, MD, USA.
Neurocrit Care. 2009;10(2):213-7. doi: 10.1007/s12028-008-9164-x. Epub 2008 Nov 15.
Stroke is the third most common cause of death in the Western World and is a condition seen by Neurologists, General Physicians and Primary Care Physicians. Neurogenic pulmonary edema can complicate the management of large strokes and cerebral hemorrhage. While the principles of management of this type of pulmonary edema are similar to the more common cardiogenic pulmonary edema, placing a patient in the prone position may be a helpful maneuver facilitating recovery.
We describe a case of basilar thrombosis treated with intra-arterial thrombolysis where prone ventilation was employed to treat neurogenic cardio-pulmonary complications.
This resulted in rapid resolution of neurogenic pulmonary edema and patient recovery after recanulation of the basilar artery by intra-arterial urokinase.
This technique of prone positioning for ventilation is of importance to physicians who manage stroke and its complications.
中风是西方世界第三大常见死因,神经科医生、普通内科医生和初级保健医生都会遇到这种病症。神经源性肺水肿会使大面积中风和脑出血的治疗变得复杂。虽然这种类型的肺水肿的治疗原则与更常见的心源性肺水肿相似,但将患者置于俯卧位可能是有助于恢复的一种操作。
我们描述了一例采用动脉内溶栓治疗基底动脉血栓形成的病例,其中采用俯卧位通气来治疗神经源性心肺并发症。
通过动脉内使用尿激酶使基底动脉再通后,神经源性肺水肿迅速消退,患者康复。
这种俯卧位通气技术对治疗中风及其并发症的医生来说很重要。