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体外膜肺氧合治疗颅内动脉瘤破裂后急性危及生命的神经源性肺水肿。

Extracorporeal membrane oxygenation for acute life-threatening neurogenic pulmonary edema following rupture of an intracranial aneurysm.

机构信息

Department of Neurosurgery, School of Medicine, Seoul National University, Seoul, Korea.

出版信息

J Korean Med Sci. 2013 Jun;28(6):962-4. doi: 10.3346/jkms.2013.28.6.962. Epub 2013 Jun 3.

Abstract

Neurogenic pulmonary edema (NPE) leading to cardiopulmonary dysfunction is a potentially life-threatening complication in patients with central nervous system lesions. This case report describes a 28-yr woman with life-threatening fulminant NPE, which was refractory to conventional respiratory treatment, following the rupture of an aneurysm. She was treated successfully with extracorporeal membrane oxygenation (ECMO), although ECMO therapy is generally contraindicated in neurological injuries such as brain trauma and diseases that are likely to require surgical intervention. The success of this treatment suggests that ECMO therapy should not be withheld from patients with life-threatening fulminant NPE after subarachnoid hemorrhage.

摘要

神经原性肺水肿(NPE)导致心肺功能障碍是中枢神经系统病变患者潜在的危及生命的并发症。本病例报告描述了一位 28 岁女性,因动脉瘤破裂导致危及生命的暴发性 NPE,常规呼吸治疗无效。她成功地接受了体外膜氧合(ECMO)治疗,尽管 ECMO 治疗通常禁忌用于脑外伤等神经损伤和可能需要手术干预的疾病。这种治疗的成功表明,在蛛网膜下腔出血后,对于危及生命的暴发性 NPE 患者,不应拒绝 ECMO 治疗。

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