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采用体外膜肺氧合技术经小切口二尖瓣修复术后成功治疗严重单侧复张性肺水肿。

Successful management of severe unilateral re-expansion pulmonary edema after mitral valve repair with mini-thoracotomy using extracorporeal membrane oxygenation.

作者信息

Kitahara Hiroto, Okamoto Kazuma, Kudo Mikihiko, Yoshitake Akihiro, Hayashi Kanako, Inaba Yu, Ai Kimiaki, Suzuki Takeshi, Morisaki Hiroshi, Shimizu Hideyuki

机构信息

Department of Cardiovascular Surgery, Keio University Hospital, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.

Department of Anesthesiology, Keio University Hospital, Tokyo, Japan.

出版信息

Gen Thorac Cardiovasc Surg. 2017 Mar;65(3):164-166. doi: 10.1007/s11748-015-0592-1. Epub 2015 Sep 28.

Abstract

A 60-year-old man received mitral valve repair via right mini-thoracotomy, which was followed by unilateral re-expansion pulmonary edema on the right side and severe hemoptysis just after the surgery. Despite differential lung ventilation with unilateral high positive end expiratory pressure was initiated for the affected right lung, respiratory function did not improved and hemodynamics was collapsed in the next day. Veno-venous extracorporeal membrane oxygenation was initiated by cannulation of the right jugular and the left femoral vein. After pulmonary function recovered gradually, veno-venous extracorporeal membrane oxygenation was terminated on the fifth postoperative day. He was discharged in ambulatory condition on postoperative day 52.

摘要

一名60岁男性接受了经右胸小切口二尖瓣修复术,术后即刻出现右侧单侧复张性肺水肿和严重咯血。尽管对患侧右肺启动了单侧高呼气末正压的差异肺通气,但呼吸功能并未改善,次日血流动力学崩溃。通过右颈静脉和左股静脉插管启动了静脉-静脉体外膜肺氧合。肺功能逐渐恢复后,术后第5天终止静脉-静脉体外膜肺氧合。术后第52天,他在病情稳定的情况下出院。

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