一名年轻女性难治性室性心律失常与无脉电活动交替发作，经体外心肺复苏成功救治
Refractory Ventricle Arrhythmias Alternating with Pulseless Electrical Activity in a Young Woman Rescued by Extracorporeal Cardiopulmonary Resuscitation.
作者信息
Lálová Ilona, Filipovská Lucie, Skalická Hana, Šmíd Ondřej, Linhart Aleš, Kollárová Helena, Bělohlávek Jan
机构信息
2nd Department of Medicine-Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague, General University Hospital in Prague, U Nemocnice 2, 128 00 Prague 2, Czech Republic.
Emergency Medical Service Prague, Korunni 98, 101 00 Prague 10, Czech Republic.
出版信息
Case Rep Med. 2018 Jan 14;2018:5686790. doi: 10.1155/2018/5686790. eCollection 2018.
INTRODUCTION
Extracorporeal cardiopulmonary resuscitation (ECPR) is a challenging approach for treating refractory out-of-hospital cardiac arrest (OHCA).
CASE PRESENTATION
The authors describe a case of a 40-year-old Caucasian female who suffered from refractory OHCA, was admitted to a hospital while receiving ongoing cardiopulmonary resuscitation, and was connected to venoarterial extracorporeal membrane oxygenation 73 minutes after collapse. Ventricular tachyarrhythmias alternating with pulseless electrical activity resolved after eight hours. Following complete cardiac and neurological recovery, only adenoviral genome was found in myocardial biopsy. After 11 months, another episode of identical arrhythmias was rescued by an implantable cardioverter-defibrillator.
CONCLUSION
Adequate prehospital and early hospital logistics is a prerequisite for successfully implementing extracorporeal cardiopulmonary resuscitation for refractory OHCA.
引言
体外心肺复苏（ECPR）是治疗难治性院外心脏骤停（OHCA）的一种具有挑战性的方法。
病例报告
作者描述了一例40岁的白种女性病例，该患者患有难治性OHCA，在持续进行心肺复苏时被送入医院，并在心脏骤停73分钟后连接到静脉 - 动脉体外膜肺氧合。室性快速心律失常与无脉电活动交替出现，8小时后得到缓解。在心脏和神经功能完全恢复后，心肌活检仅发现腺病毒基因组。11个月后，植入式心脏复律除颤器成功挽救了另一例相同心律失常发作。
结论
充分的院前和早期医院后勤保障是成功实施难治性OHCA体外心肺复苏的先决条件。
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