Beshish Asaad G, Weinberg Allison, Ostwani Waseem, Owens Gabe E
Pediatric Critical Fellow, Department of Pediatrics, Division of Pediatric Critical Care Medicine, University of Michigan, C.S. Mott Children's Hospital, Ann Arbor, Michigan.
Certified Clinical Perfusionist, Department of ECMO, University of Michigan, Ann Arbor, Michigan.
J Extra Corpor Technol. 2017 Dec;49(4):312-316.
We describe the use of extracorporeal cardiopulmonary resuscitation (E-CPR) to transiently stabilize a 3-month-old patient who presented with ventricular tachyarrhythmias leading to spontaneous cardiac arrest. The patient required 4 days of extracorporeal life support (ECLS) where he was diagnosed with probable Brugada syndrome (BS). The patient was discharged home in stable condition after implantable cardioverter defibrillator placement. This case highlights the importance of early transfer to extracorporeal membrane oxygenation (ECMO) center in the setting of unexplained cardiac arrhythmia in a pediatric patient. BS is an autosomal dominant genetic disorder with variable expression characterized by abnormal findings on electrocardiogram (ECG) in conjunction with an increased risk of ventricular tachyarrhythmias and sudden cardiac arrest (SCA). Early management is critical and early consideration to transfer to an institution where extracorporeal life support (ECLS/ECMO) is present to support the patient while further diagnostic work up is in progress is lifesaving.
我们描述了使用体外心肺复苏术（E-CPR）来短暂稳定一名3个月大的患者，该患者出现室性快速心律失常并导致心脏骤停。患者需要4天的体外生命支持（ECLS），期间被诊断为可能患有Brugada综合征（BS）。在植入植入式心脏复律除颤器后，患者病情稳定出院。该病例强调了在儿科患者出现不明原因心律失常的情况下，早期转至体外膜肺氧合（ECMO）中心的重要性。BS是一种常染色体显性遗传病，表现多样，其特征是心电图（ECG）有异常表现，同时室性快速心律失常和心脏骤停（SCA）风险增加。早期管理至关重要，在进一步诊断检查进行期间，尽早考虑将患者转至具备体外生命支持（ECLS/ECMO）的机构以支持患者，这可能挽救生命。
