致命性空气栓塞作为体外膜肺氧合静脉-静脉模式下经皮扩张气管切开术的并发症：两例报告
Fatal air embolism as complication of percutaneous dilatational tracheostomy on venovenous extracorporeal membrane oxygenation, two case reports.
作者信息
Lother Achim, Wengenmayer Tobias, Benk Christoph, Bode Christoph, Staudacher Dawid L
机构信息
Department of Cardiology and Angiology I, Heart Center Freiburg University, Hugstetterstrasse 55, 79106, Freiburg, Germany.
Department of Cardiovascular Surgery, Heart Center Freiburg University, Freiburg, Germany.
出版信息
J Cardiothorac Surg. 2016 Jul 11;11(1):102. doi: 10.1186/s13019-016-0489-9.
Abstract
BACKGROUND
Tracheostomy is recommended in case of prolonged mechanical ventilation. Therefore, most patients with an indication for venovenous extracorporeal membrane oxygenation (ECMO) will also have an indication for tracheostomy.
CASE PRESENTATION
We report 2 cases of fatal air embolism into the ECMO system as complication of percutaneous dilatational tracheostomy. Both patients had an AVALON ELITE® bi-caval cannula implanted draining blood from the vena cava superior and inferior.
CONCLUSION
Since there is limited safety data on this specific group of patients, a routine early dilatational tracheostomy might be associated with a significant risk.
摘要
背景
对于长时间机械通气的情况，建议进行气管切开术。因此，大多数有静脉-静脉体外膜肺氧合（ECMO）指征的患者也有气管切开术的指征。
病例报告
我们报告2例经皮扩张气管切开术并发症导致致命空气栓塞进入ECMO系统的病例。两名患者均植入了AVALON ELITE®双腔插管，用于引流上、下腔静脉的血液。
结论
由于关于这一特定患者群体的安全数据有限，常规早期扩张气管切开术可能存在重大风险。
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