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肥厚型梗阻性心肌病患儿的治疗性低温与院外心脏骤停

Therapeutic Hypothermia and Out-of-Hospital Cardiac Arrest in a Child with Hypertrophic Obstructive Cardiomyopathy.

作者信息

Spurkeland Nancy, Bennett Gregory, Alexander Chandran, Chang Dennis, Ceneviva Gary

机构信息

Penn State Hershey College of Medicine, Hershey, PA 17033, USA.

Department of Pediatrics, Hershey Medical Center, Hershey, PA 17033, USA.

出版信息

Case Rep Pediatr. 2015;2015:796151. doi: 10.1155/2015/796151. Epub 2015 Mar 16.

Abstract

Neurologic outcomes following pediatric cardiac arrest are consistently poor. Early initiation of cardiopulmonary resuscitation has been shown to have positive effects on both survival to hospital discharge, and improved neurological outcomes after cardiac arrest. Additionally, the use of therapeutic hypothermia may improve survival in pediatric cardiac arrest patients admitted to the intensive care unit. We report a child with congenital hypertrophic obstructive cardiomyopathy and an out-of-hospital cardiac arrest, in whom the early initiation of effective prolonged cardiopulmonary resuscitation and subsequent administration of therapeutic hypothermia contributed to a positive outcome with no gross neurologic sequelae. Continuing efforts should be made to promote and employ high-quality cardiopulmonary resuscitation, which likely contributed to the positive outcome of this case. Further research will be necessary to develop and solidify national guidelines for the implementation of therapeutic hypothermia in selected subpopulations of children with OHCA.

摘要

小儿心脏骤停后的神经学预后一直很差。已证明早期开始心肺复苏对存活至出院以及改善心脏骤停后的神经学预后均有积极作用。此外,治疗性低温的应用可能会提高入住重症监护病房的小儿心脏骤停患者的存活率。我们报告了一名患有先天性肥厚性梗阻性心肌病并发生院外心脏骤停的儿童,在该病例中,早期开始有效的长时间心肺复苏以及随后给予治疗性低温促成了良好的结局,且无明显神经后遗症。应持续努力推广和采用高质量的心肺复苏,这可能是该病例取得良好结局的原因。有必要进行进一步研究,以制定和完善针对特定亚群的院外心脏骤停儿童实施治疗性低温的国家指南。

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