Department of Surgery and Traumatology, National Taiwan University Hospital, Taipei, Taiwan.
Thyroid. 2011 Apr;21(4):439-41. doi: 10.1089/thy.2010.0230. Epub 2011 Mar 8.
Heart failure is one of the best-known complications of thyrotoxicosis. Thyrotoxicosis-induced heart failure sometimes causes circulatory collapse with a high mortality. There is little published information regarding venous-artery mode extracorporeal membrane oxygenation (V-A mode ECMO) to treat circulatory collapse in patients with thyrotoxicosis. Here, we present four patients who received this treatment.
We present four patients of severe heart failure secondary to severe thyrotoxicosis. All patients suffered from cardiovascular collapse initially. In addition to primary resuscitation and the antithyroid drugs provided, ECMO was applied for temporally hemodynamic support. One patient expired, and the other three patients successfully recovered from heart failure under the support of V-A mode ECMO. The thyroid function also returned to normal range.
Patients experiencing heart failure due to severe thyrotoxicosis should be admitted to intensive care unit for close hemodynamic monitor. In addition, mechanical circulatory support such as ECMO should be provided immediately once circulatory collapse occurs.
心力衰竭是甲状腺毒症最常见的并发症之一。甲状腺毒症引起的心力衰竭有时会导致循环崩溃,死亡率很高。关于静脉-动脉模式体外膜肺氧合(V-A 模式 ECMO)治疗甲状腺毒症患者循环崩溃的文献报道很少。在这里,我们介绍了接受这种治疗的四名患者。
我们介绍了四名因严重甲状腺毒症继发严重心力衰竭的患者。所有患者最初均出现心血管崩溃。除了提供初步复苏和抗甲状腺药物外,还应用 ECMO 进行暂时的血液动力学支持。一名患者死亡,另外三名患者在 V-A 模式 ECMO 的支持下成功从心力衰竭中恢复。甲状腺功能也恢复正常范围。
因严重甲状腺毒症导致心力衰竭的患者应入住重症监护病房进行密切的血流动力学监测。此外,一旦发生循环崩溃,应立即提供机械循环支持,如 ECMO。