使用LUCAS系统进行院外复苏后出现意外的附带影响。
Unexpected collateral impact after out of hospital resuscitation using LUCAS system.
作者信息
Shahinian Jasmin Hasmik, Quitt Jonas, Wiese Mark, Eckstein Friedrich, Reuthebuch Oliver
机构信息
Department of Cardiac Surgery, University Hospital Basel, Spitalstrasse 21, CH-4031, Basel, Switzerland.
Department of Anesthesiology, University Hospital Basel, Basel, Switzerland.
出版信息
J Cardiothorac Surg. 2017 Sep 7;12(1):81. doi: 10.1186/s13019-017-0643-z.
BACKGROUND
Mechanical chest compression using a piston device during reanimation is often the only way to ensure stable chest compression at a constant rate and force. However, its use can be associated with severe fractures of the thoracic rib cage and endanger the clinical course of the patient. Thus, the usage of such a piston device during the reanimation has currently been classified as a mere Class IIB indication.
CASE PRESENTATION
We present a case of a 66-year-old male who underwent emergent CABG surgery after receiving out-of-hospital resuscitation as a result of myocardial infarction using the LUCAS system. Due to severe bilateral rib fractures a concomitant emergency chest-wall stabilization surgery had to be performed to ensure uncompromised graft flow to obtain stable cardiac function and hemodynamics.
CONCLUSIONS
Reanimation using LUCAS-System might enable stable resuscitation conditions. However, it is crucial not to underestimate potential collateral damage which can in turn aggravate patient's clinical condition.
背景
在复苏过程中使用活塞装置进行机械胸外按压通常是确保以恒定速率和力量进行稳定胸外按压的唯一方法。然而，其使用可能与胸廓严重骨折相关，并危及患者的临床病程。因此，目前在复苏过程中使用这种活塞装置仅被列为IIB类适应症。
病例报告
我们报告一例66岁男性病例，该患者因心肌梗死在院外接受复苏后使用LUCAS系统进行了急诊冠状动脉旁路移植术（CABG）。由于双侧肋骨严重骨折，不得不进行急诊胸壁稳定手术，以确保移植物血流不受影响，从而获得稳定的心脏功能和血流动力学。
结论
使用LUCAS系统进行复苏可能会实现稳定的复苏条件。然而，至关重要的是不要低估潜在的附带损害，这反过来可能会加重患者的临床状况。
Zotero 插件