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经皮心肺支持治疗眼科手术中疑似静脉空气栓塞伴心脏骤停:一例报告。

Percutaneous cardiopulmonary support to treat suspected venous air embolism with cardiac arrest during open eye surgery: a case report.

机构信息

Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Yonsei University Health System, Seoul, Korea. ; Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Yonsei University Health System, Seoul, Korea.

Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Yonsei University Health System, Seoul, Korea.

出版信息

Korean J Anesthesiol. 2014 Nov;67(5):350-3. doi: 10.4097/kjae.2014.67.5.350. Epub 2014 Nov 26.

Abstract

We report a case of possible venous air embolism (VAE) during trans pars plana vitrectomy with air-fluid exchange of the vitreous cavity. Shortly after initiation of air-fluid exchange, decreases in end-tidal CO2, oxygen saturation, and blood pressure were observed. The patient rapidly progressed to cardiac arrest unresponsive to cardiopulmonary resuscitation, and recovered after the application of percutaneous cardiopulmonary support. Prompt termination of air infusion is needed when VAE is suspected during air-fluid exchange, and extracorporeal life support should be considered in fatal cases. Although the incidence is rare the possibility of VAE during ophthalmic surgery clearly exists, and therefore awareness and vigilant monitoring seem critical.

摘要

我们报告了一例在经睫状体平坦部玻璃体切割术联合玻璃体腔气液交换过程中发生静脉空气栓塞(VAE)的可能性病例。在开始进行气液交换后不久,观察到呼气末 CO2、氧饱和度和血压下降。患者迅速进展为心肺复苏无反应的心脏骤停,并在应用体外心肺支持后恢复。当怀疑在气液交换过程中发生 VAE 时,需要迅速停止空气输注,并且在致命病例中应考虑体外生命支持。尽管发病率较低,但眼科手术过程中确实存在 VAE 的可能性,因此意识和警惕监测至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f42/4252349/a6b2d8bfa23e/kjae-67-350-g001.jpg

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