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一名钝性创伤且心脏骤停的患者在急诊科无脉搏送达;这足以成为停止复苏的理由吗?文献综述与病例报告

A Patient With Blunt Trauma and Cardiac Arrest Arriving Pulseless at the Emergency Department; is that Enough Reason to Stop Resuscitation? Review of Literature and Case Report.

作者信息

Hamidian Jahromi Alireza, Northcutt Ashley, Youssef Asser M

机构信息

Department of Surgery, Louisiana State University Health Sciences Center, Shreveport, Louisiana, USA.

出版信息

Iran Red Crescent Med J. 2013 Dec;15(12):e11623. doi: 10.5812/ircmj.11623. Epub 2013 Dec 5.

Abstract

The decision to stop or continue resuscitation in a patient with blunt trauma and cardiac arrest arriving pulseless to the hospital has always been controversial. While many authors still believe that it is a futile effort, with no chance of success for complete neurological recovery, some recent reports have challenged the idea. Here we report complete recovery of a severely injured patient following a motor vehicle accident who lost vital signs completely before arrival at our trauma center. No cardiac motion was detected on ultrasound examination on arrival. Emergency department thoracotomy, open cardiac massage, massive blood transfusion, damage control laparotomy with abdominal and pelvic packing, followed by angio-embolization of pelvic bleeding, and staged abdominal exploration were performed. This case is an example showing that resuscitation of patients with blunt trauma and cardiac arrest arriving pulseless to the hospital is not always futile.

摘要

对于钝性创伤且心脏骤停、无脉搏送达医院的患者,决定停止或继续复苏一直存在争议。尽管许多作者仍认为这是徒劳之举,完全恢复神经功能毫无成功的可能,但最近一些报告对这一观点提出了挑战。在此,我们报告一名在机动车事故中严重受伤的患者完全康复的案例,该患者在到达我们的创伤中心之前生命体征完全消失。到达时超声检查未检测到心脏活动。进行了急诊开胸手术、开胸心脏按压、大量输血、腹部和盆腔填塞的损伤控制剖腹术,随后对盆腔出血进行血管栓塞,以及分期腹部探查。该病例表明,钝性创伤且心脏骤停、无脉搏送达医院的患者复苏并非总是徒劳的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f9c5/3955500/714e66310abe/ircmj-15-11623-g001.jpg

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