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[严重多发伤合并心脏挫伤导致的冠状动脉广泛夹层:静脉-动脉体外膜肺氧合辅助下的经皮冠状动脉介入治疗]

[Extended coronary dissection caused by severe polytrauma with contusio cordis : Venoarterial ECMO-assisted percutaneous coronary intervention].

作者信息

Dreher M, Grawe A, Albert D, Beck G, Ferrari M

机构信息

Klinik für Innere Medizin I, Kardiologie, konservative Intensivmedizin, Angiologie, HSK, Dr. Horst Schmidt Kliniken GmbH - Städtisches Klinikum der Landeshauptstadt Wiesbaden und der Helios-Kliniken GmbH, Ludwig-Erhard-Str. 100, 65199, Wiesbaden, Deutschland.

Anästhesiologie, Intensivmedizin und Schmerztherapie, HSK, Dr. Horst Schmidt Kliniken GmbH - Städtisches Klinikum der Landeshauptstadt Wiesbaden und der Helios-Kliniken GmbH, Wiesbaden, Deutschland.

出版信息

Med Klin Intensivmed Notfmed. 2016 May;111(4):325-9. doi: 10.1007/s00063-015-0049-4. Epub 2015 Jul 8.

Abstract

Treatment of a patient with acute cardiac failure due to a contusio cordis after polytrauma by an interdisciplinary team is reported. Shortly after admission to our shock room, the patient developed cardiogenic shock caused by an extended coronary dissection. After interim cardiopulmonary resuscitation, the patient was stabilized by venoarterial extracorporeal membrane oxygenation (ECMO) and subsequent complex coronary artery intervention in the heart catheter laboratory. Despite the increased left ventricular function which enabled partial weaning from the ECMO, the patient died of multiple organ failure 10 days after admission.

摘要

本文报道了一个多学科团队对一名因多处创伤后心脏挫伤导致急性心力衰竭患者的治疗情况。患者被送入我们的休克病房后不久,因广泛性冠状动脉夹层形成而发生心源性休克。经过临时心肺复苏后,患者通过静脉-动脉体外膜肺氧合(ECMO)以及随后在心脏导管室进行的复杂冠状动脉介入治疗得以稳定。尽管左心室功能有所改善,使得患者能够部分撤离ECMO,但患者在入院10天后死于多器官功能衰竭。

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