Fikry Karim, Blute Michael L, Sundt Thoralf M, McKeen Mark
From the *Department of Anesthesia, Critical Care and Pain Medicine, †Department of Urology, and ‡Department of Cardiac Surgery, Massachusetts General Hospital, Boston, Massachusetts.
A A Case Rep. 2015 May 1;4(9):117-9. doi: 10.1213/XAA.0000000000000142.
We report a case of cardiac arrest secondary to pulmonary tumor embolization occurring in a patient undergoing nephrectomy for renal cell carcinoma with a tumor thrombus invading the inferior vena cava infrahepatically. Tumor embolization in such cases is very rare (1.5%), but if it occurs, mortality is 75%. In our case, resources were rapidly mobilized, and cardiopulmonary bypass was initiated for pulmonary embolectomy within 34 minutes of the cardiac arrest. The patient's trachea was extubated on postoperative day 1, and he was discharged home 9 days later neurologically intact. Excellent preoperative and intraoperative communication among all involved health care providers, as well as rapid mobilization of the available resources, played important roles in the patient's positive outcome.
我们报告了一例继发于肺肿瘤栓塞的心脏骤停病例，该病例发生在一名因肾细胞癌伴肿瘤血栓侵犯肝下下腔静脉而接受肾切除术的患者身上。此类病例中的肿瘤栓塞非常罕见（1.5%），但一旦发生，死亡率为75%。在我们的病例中，资源迅速调集，心脏骤停后34分钟内即启动体外循环进行肺栓子切除术。患者术后第1天拔除气管插管，9天后神经功能完好出院回家。所有参与的医疗保健提供者之间出色的术前和术中沟通，以及可用资源的迅速调集，对患者的良好预后起到了重要作用。
