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心脏手术后难治性低氧血症和肺叶肺不张的肺泡复张手法：一例报告

Alveolar recruitment maneuver in refractory hypoxemia and lobar atelectasis after cardiac surgery: a case report.

作者信息

Herbst-Rodrigues Marcus Vinicius, Carvalho Vitor Oliveira, Abrahao Ludhmila Hajjar, Nozawa Emilia, Feltrim Maria Ignez Zanetti, Gomes-Galas Filomena Regina Barbosa

机构信息

Physiotherapy Department, Heart Institute (InCor), University of Sao Paulo Medical School, Sao Paulo, Brazil.

出版信息

J Cardiothorac Surg. 2012 Jun 22;7:58. doi: 10.1186/1749-8090-7-58.

DOI:10.1186/1749-8090-7-58
PMID:22726992
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3567961/
Abstract

OBJECTIVE

This case report describes an unusual presentation of right upper lobe atelectasis associated with refractory hypoxemia to conventional alveolar recruitment maneuvers in a patient soon after coronary artery bypass grafting surgery.

METHOD

Case-report.

RESULTS

The alveolar recruitment with PEEP = 40 cm H2O improved the patient's atelectasis and hypoxemia.

CONCLUSION

In the present report, the unusual alveolar recruitment maneuver with PEEP 40 cm H2O showed to be safe and efficient to reverse refractory hypoxemia and uncommon atelectasis in a patient after cardiac surgery.

摘要

目的

本病例报告描述了一名冠状动脉搭桥手术后不久的患者，出现右上叶肺不张并伴有对传统肺泡复张手法难治性低氧血症的不寻常表现。

方法

病例报告。

结果

呼气末正压（PEEP）为40 cm H₂O的肺泡复张改善了患者的肺不张和低氧血症。

结论

在本报告中，呼气末正压40 cm H₂O的不寻常肺泡复张手法显示对逆转心脏手术后患者的难治性低氧血症和罕见的肺不张是安全有效的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f1b5/3567961/ab18603913ad/1749-8090-7-58-4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f1b5/3567961/48f000448623/1749-8090-7-58-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f1b5/3567961/face069277ff/1749-8090-7-58-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f1b5/3567961/b9d4e10476e2/1749-8090-7-58-3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f1b5/3567961/ab18603913ad/1749-8090-7-58-4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f1b5/3567961/48f000448623/1749-8090-7-58-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f1b5/3567961/face069277ff/1749-8090-7-58-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f1b5/3567961/b9d4e10476e2/1749-8090-7-58-3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f1b5/3567961/ab18603913ad/1749-8090-7-58-4.jpg

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[Alveolar recruitment maneuver to reverse hypoxemia in the immediate postoperative period of cardiac surgery.].[肺泡复张手法用于逆转心脏手术后即刻低氧血症。]
Rev Bras Anestesiol. 2007 Oct;57(5):476-88. doi: 10.1590/s0034-70942007000500003.
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Hypoxemia after myocardial revascularization: analysis of risk factors.
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Rev Bras Anestesiol. 2008 Mar-Apr;58(2):124-36. doi: 10.1590/s0034-70942008000200005.
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Reversibility of lung collapse and hypoxemia in early acute respiratory distress syndrome.早期急性呼吸窘迫综合征中肺萎陷和低氧血症的可逆性
Am J Respir Crit Care Med. 2006 Aug 1;174(3):268-78. doi: 10.1164/rccm.200506-976OC. Epub 2006 May 11.
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Effect of positive pressure on venous return in volume-loaded cardiac surgical patients.正压对容量负荷型心脏手术患者静脉回流的影响。
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