Retamal Jaime, Bachler Jean, Mejía Ricardo, Concha Orlando, Andresen Max
Departamento de Medicina Intensiva, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago de Chile.
Rev Med Chil. 2011 Sep;139(9):1201-5. Epub 2011 Nov 17.
To improve survival and reduce neurological injury, the use of mild hypothermia following cardiac arrest has been recommended. We report a 65 years old woman who presented an out-of-hospital ventricular fibrillation and cardiac arrest. The patient was comatose following initial resuscitation and was admitted into the ICU, where cooling was initiated using an intravascular catheter. After 48 hours, rewarming was initiated. Although no neurological impairment was observed, physical examination of the right inguinal area and echo-Doppler examination revealed an extensive catheter-related thrombophlebitis with right ileocaval vein occlusion., with high risk of massive and life threatening pulmonary embolism. We report a clinical case and review the literature to point out the need for a high index of diagnostic suspicion of deep venous thrombosis in these specific setting.
为提高生存率并减少神经损伤，有人建议在心脏骤停后使用轻度低温治疗。我们报告了一名65岁女性，她在院外发生心室颤动和心脏骤停。患者在初始复苏后昏迷，被收入重症监护病房，在那里使用血管内导管开始降温。48小时后开始复温。尽管未观察到神经功能损害，但右侧腹股沟区体格检查和超声多普勒检查显示广泛的导管相关性血栓性静脉炎伴右侧髂总静脉闭塞，有发生大面积危及生命的肺栓塞的高风险。我们报告了一个临床病例并回顾文献，以指出在这些特定情况下对深静脉血栓形成要有高度诊断怀疑指数的必要性。
