Liang Yafen, Bennett Jeremy M, Coursin Douglas B, Rice Mark J
From the *Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee; and †Department of Anesthesiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
A A Case Rep. 2017 Oct 15;9(8):236-238. doi: 10.1213/XAA.0000000000000575.
Cardiogenic shock from acute severe mitral valve regurgitation can cause acute liver failure due to hypoperfusion. Impaired liver glycogenesis can then lead to profound hypoglycemia. The time frame for restoring normoglycemia without neurologic sequelae is not clearly established in humans. Thus, the clinical decision to provide further resuscitation in the setting of extreme hypoglycemia mainly depends on the patient's overall clinical condition, provider opinion, and/or institutional practice. Here, we report a case where the patient made complete neurologic recovery from extreme hypoglycemia (<5 mg/dL by central laboratory testing) secondary to acute cardiogenic shock and liver failure.
急性严重二尖瓣反流所致的心源性休克可因灌注不足导致急性肝衰竭。肝脏糖原生成受损进而可导致严重低血糖。在人类中,恢复正常血糖且无神经后遗症的时间框架尚未明确确立。因此,在极严重低血糖情况下决定是否进一步进行复苏的临床决策主要取决于患者的整体临床状况、医疗人员的意见和/或机构的做法。在此,我们报告一例患者,该患者继发于急性心源性休克和肝衰竭的极严重低血糖(中心实验室检测<5mg/dL)后实现了完全的神经功能恢复。