在急诊科使用体外膜肺氧合和外科血栓切除术治疗大面积肺栓塞
Use of Extracorporeal Membrane Oxygenation and Surgical Embolectomy for Massive Pulmonary Embolism in the Emergency Department.
作者信息
Russ De Ante, Payne Nicole, Bonnell Mark, Kazan Viviane
机构信息
University of Toledo College of Medicine, Toledo, Ohio.
Department of Emergency Medicine, University of Toledo College of Medicine, Toledo, Ohio.
出版信息
J Emerg Med. 2017 Nov;53(5):708-711. doi: 10.1016/j.jemermed.2017.08.072.
BACKGROUND
Massive pulmonary embolism (PE) carries significant morbidity and mortality with current standard of care modalities.
CASE REPORT
We present the case of a 63-year-old male status post abdominal surgery 2 weeks before presenting to the emergency department with a massive pulmonary embolism and subsequent acute cardiopulmonary failure. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Here we describe a case of extracorporeal membrane oxygenation (ECMO) deployed in the emergency department as a bridge to embolectomy to successfully treat massive pulmonary embolism. This provided the opportunity to establish a "Code ECMO" protocol and algorithm for PE with cardiopulmonary instability so that patients can be rapidly triaged to the appropriate treatment modality.
背景
按照当前的护理标准模式，大面积肺栓塞（PE）会导致显著的发病率和死亡率。
病例报告
我们报告一例63岁男性病例，该患者在腹部手术后2周因大面积肺栓塞及随后的急性心肺衰竭就诊于急诊科。为什么急诊医生应该了解这个病例呢？在此，我们描述了在急诊科部署体外膜肺氧合（ECMO）作为栓子切除术桥梁以成功治疗大面积肺栓塞的病例。这为建立针对伴有心肺不稳定的肺栓塞的“ECMO代码”方案和算法提供了机会，以便能够将患者迅速分诊至合适的治疗模式。
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