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清醒患者的静脉-动脉体外膜肺氧合:移动体外膜肺氧合团队用于暴发性肺栓塞的治疗

[Venoarterial extracorporeal membrane oxygenation in an awake patient : Use of the mobile ECMO team for fulminant pulmonary embolism].

作者信息

Keller D, Lotz C, Kippnich M, Adami P, Kranke P, Roewer N, Kredel M, Schimmer C, Leyh R, Muellenbach R M

机构信息

Klinik und Poliklinik für Anästhesiologie, Universitätsklinikum Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Deutschland.

出版信息

Anaesthesist. 2015 May;64(5):385-9. doi: 10.1007/s00101-015-0025-7. Epub 2015 Apr 21.

Abstract

The current report highlights the use of venoarterial extracorporeal membrane oxygenation (va-ECMO) in a case of pulmonary embolism complicated by right ventricular failure. A 38-year-old woman was admitted to a secondary care hospital with dyspnea and systemic hypotension. Diagnostic testing revealed a massive pulmonary embolism. Thrombolytic therapy was unsuccessful necessitating thromboendarterectomy in the presence of cardiogenic shock. To allow the necessary transport of the highly unstable patient to a tertiary care center a mobile ECMO team was called in. The team immediately initiated awake va-ECMO as a bridge to therapy. Extracorporeal support subsequently allowed a safe transportation and successful completion of the surgical procedure with complete recovery.

摘要

本报告重点介绍了静脉-动脉体外膜肺氧合(va-ECMO)在一例合并右心室衰竭的肺栓塞病例中的应用。一名38岁女性因呼吸困难和全身性低血压入住二级护理医院。诊断检查显示为大面积肺栓塞。溶栓治疗未成功,在存在心源性休克的情况下需要进行血栓内膜切除术。为了将这名高度不稳定的患者安全转运至三级护理中心,呼叫了移动ECMO团队。该团队立即启动清醒状态下的va-ECMO作为治疗桥梁。体外支持随后实现了安全转运,并成功完成了手术,患者完全康复。

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