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伴有声门上及气管梗阻的咽后纵隔血肿:多学科气道管理的作用

A retropharyngeal-mediastinal hematoma with supraglottic and tracheal obstruction: The role of multidisciplinary airway management.

作者信息

Birkholz Torsten, Kröber Stefanie, Knorr Christian, Schiele Albert, Bumm Klaus, Schmidt Joachim

机构信息

Department of Anesthesiology, University Hospital Erlangen, Krankenhausstr. 12, D-91054, Erlangen, Germany.

出版信息

J Emerg Trauma Shock. 2010 Oct;3(4):409-11. doi: 10.4103/0974-2700.70776.

Abstract

A 77-year-old man suffered hypoxemic cardiac arrest by supraglottic and tracheal airway obstruction in the emergency department. A previously unknown cervical fracture had caused a traumatic retropharyngeal-mediastinal hematoma. A lifesaving surgical emergency tracheostomy succeeded. Supraglottic and tracheal obstruction by a retropharyngeal-mediastinal hematoma with successful resuscitation via emergency tracheostomy after hypoxemic cardiac arrest has never been reported in a context of trauma. This clinically demanding case outlines the need for multidisciplinary airway management systems with continuous training and well-implemented guidelines. Only multidisciplinary staff preparedness and readily available equipments for the unanticipated difficult airway solved the catastrophic clinical situation.

摘要

一名77岁男性在急诊科因声门上和气管气道阻塞发生低氧性心脏骤停。一处此前未知的颈椎骨折导致创伤性咽后纵隔血肿。一次挽救生命的紧急气管切开术取得成功。创伤背景下,因咽后纵隔血肿导致声门上和气管阻塞,经紧急气管切开术后成功复苏,此前未见报道。这个临床要求高的病例凸显了建立多学科气道管理系统并持续培训和切实执行指南的必要性。只有多学科人员做好准备以及随时可用应对意外困难气道的设备,才能解决这一灾难性临床情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d693/2966579/72480122c241/JETS-3-409-g001.jpg

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