Ting Joseph Y, Dehdary Arash
Department of Emergency Medicine, Mater Public Hospitals, South Brisbane 4101, Australia.
Int J Emerg Med. 2011 Apr 28;4(1):20. doi: 10.1186/1865-1380-4-20.
Acute aortic occlusion is a rare but catastrophic disease with a high mortality rate. Severe perioperative complications could result from revascularization of infarcted muscles. Muscle cell ischaemia and massive volume cell death lead to the release of myoglobin, potassium, and lactic acid, which could be fatal if not recognised or treated early. We highlight the life-threatening adverse effects resulting from bulk tissue infarction from non-traumatic causes such as aortic occlusion followed by the metabolic sequelae of reperfusion. This is similar to the pathophysiology of traumatic crush injuries and rhabdomyolysis. The case highlights the vigorous pre-emptive treatment of acidosis and hyperkalaemia required during surgical revascularisation to potentially avert adverse surgical outcomes in acute aortic obstruction.
急性主动脉闭塞是一种罕见但灾难性的疾病，死亡率很高。梗死肌肉的血运重建可能导致严重的围手术期并发症。肌肉细胞缺血和大量细胞死亡会导致肌红蛋白、钾和乳酸的释放，如果不及早识别或治疗，可能会致命。我们强调了由非创伤性原因（如主动脉闭塞）导致的大块组织梗死以及再灌注的代谢后遗症所产生的危及生命的不良反应。这与创伤性挤压伤和横纹肌溶解的病理生理学相似。该病例突出了手术血运重建期间对酸中毒和高钾血症进行积极的预防性治疗，以潜在避免急性主动脉梗阻的不良手术结局。
