Advanced Medical Emergency and Critical Care Center, Yamaguchi University Hospital, Japan.
J Cardiol. 2009 Dec;54(3):480-4. doi: 10.1016/j.jjcc.2009.02.016. Epub 2009 Apr 9.
This report describes a patient who experienced cardiopulmonary arrest caused by severe hypoglycemia and malnutrition, which was successfully treated with percutaneous cardiopulmonary support (PCPS) and intra-aortic balloon pumping (IABP). A 33-year-old female with anorexia nervosa (AN) was transferred to the emergency center because of a loss of consciousness. On admission, she was extremely emaciated, hypotensive, and hypoglycemic (10 mg/dl). A chest X-ray showed butterfly shadow. Echocardiography showed severe hypokinesis of left ventricular wall motion. On the 3rd hospital day, she experienced cardiac arrest. Myocardial dysfunction caused by malnutrition was suspected, and therefore both PCPS and IABP were administered for circulatory support and myocardial protection. Thereafter, cardiac function gradually recovered and she was later weaned from PCPS and IABP on the 9th and the 10th hospital day, respectively. She was discharged from the intensive care unit on the 43rd hospital day with normal cardiac function. Her neurological outcome after 6 months as evaluated by the Glasgow Outcome Scale was considered to be good recovery. Cardiomyopathy in AN patients is reversible ventricular dysfunction, and circulation assisting devices are considered for the treatment of cardiogenic shock.
本报告描述了一位因严重低血糖和营养不良导致心肺骤停的患者，该患者经皮心肺支持（PCPS）和主动脉内球囊反搏（IABP）治疗后成功获救。一位 33 岁的女性厌食症（AN）患者因意识丧失被转至急诊中心。入院时，她非常消瘦、低血压、低血糖（10mg/dl）。X 光胸片显示蝶形阴影。超声心动图显示左心室壁运动严重减弱。入院第 3 天，她发生了心脏骤停。怀疑是由营养不良引起的心肌功能障碍，因此给予 PCPS 和 IABP 以进行循环支持和心肌保护。此后，心脏功能逐渐恢复，她分别在第 9 天和第 10 天成功撤机。入院第 43 天，她在心功能正常的情况下从重症监护病房出院。她在 6 个月后的神经功能预后评估为格拉斯哥结果量表良好恢复。AN 患者的心肌病是可逆性心室功能障碍，可考虑使用循环辅助设备治疗心源性休克。
