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心搏骤停昏迷患者行经皮冠状动脉介入治疗失败后急诊冠状动脉旁路移植术后的治疗性低温。

Therapeutic hypothermia following emergent coronary artery bypass grafting after failed percutaneous coronary intervention in a comatose post-cardiac arrest patient.

机构信息

Department of Emergency Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.

出版信息

J Korean Med Sci. 2013 Aug;28(8):1257-9. doi: 10.3346/jkms.2013.28.8.1257. Epub 2013 Jul 31.

Abstract

We report the case of 60-yr-old female in which therapeutic hypothermia (TH) was successfully induced maintaining the target temperature of 34℃ for 12 hr despite a risk of hypothermia-induced coagulation abnormalities following an emergent coronary artery bypass grafting (CABG) due to failed percutaneous coronary intervention, who suffered a cardiac arrest. Emergent CABG may be a relative contraindication for TH in post-cardiac arrest patients because hypothermia may increase the risk of infection and bleeding. However, the possibility of an improved neurologic outcome outweighs the risk of bleeding, although major surgery may be a relative contraindication for TH.

摘要

我们报告了一例 60 岁女性病例,尽管在经皮冠状动脉介入治疗失败后紧急进行冠状动脉旁路移植术(CABG)会有导致低温诱导性凝血异常的风险,但通过维持目标体温 34℃达 12 小时,成功诱导了治疗性低温。该患者发生了心脏骤停。对于心脏骤停后患者,紧急 CABG 可能是治疗性低温的相对禁忌证,因为低温可能会增加感染和出血的风险。然而,神经功能改善的可能性超过了出血的风险,尽管大手术可能是治疗性低温的相对禁忌证。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1ead/3744719/87cf231f0cc5/jkms-28-1257-g001.jpg

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