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肺动脉漂浮导管联合泵控逆行试验撤机用于静脉-动脉体外膜肺氧合撤机的病例报告

Pulmonary artery flotation catheter combined with pump-controlled retrograde trial off as a trial for weaning from veno-arterial extracorporeal membrane oxygenation: a case report.

作者信息

Xu Ying, Gu Qin

机构信息

Department of Intensive Care Unit, The Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School, Nanjing, China.

出版信息

Perfusion. 2019 Sep;34(6):519-522. doi: 10.1177/0267659118824219. Epub 2019 Feb 8.

Abstract

BACKGROUND

The Swan-Ganz catheter is a reliable method used to monitor hemodynamics in intensive care units. Pump-controlled retrograde trial off is a new weaning test for veno-arterial extracorporeal membrane oxygenation in recent years. The objective of this report is to describe a case in which pulmonary artery flotation catheter hemodynamic monitoring in combination with pump-controlled retrograde trial off was sufficient for veno-arterial extracorporeal membrane oxygenation weaning.

METHODS

We report the case of an adolescent patient with acute heart failure due to acute severe myocarditis in veno-arterial extracorporeal membrane oxygenation, intra-aortic balloon pump, and pulmonary artery flotation catheter hemodynamic monitoring.

RESULTS

Pulmonary artery flotation catheter hemodynamic monitoring pre- and post pump-controlled retrograde trial off was successfully proven to predict decannulation success. The patient was weaned off of the extracorporeal membrane oxygenation, intra-aortic balloon pump, and pulmonary artery flotation catheter. His cardiac function gradually recovered, and he was discharged.

CONCLUSION

The combination of pulmonary artery flotation catheter hemodynamic monitoring and pump-controlled retrograde trial off can increase the possibility of veno-arterial extracorporeal membrane oxygenation successful decannulation.

摘要

背景

Swan-Ganz导管是重症监护病房中用于监测血流动力学的可靠方法。近年来,泵控逆行试验关闭是一种用于静脉-动脉体外膜肺氧合的新型撤机试验。本报告的目的是描述一例将肺动脉漂浮导管血流动力学监测与泵控逆行试验关闭相结合足以实现静脉-动脉体外膜肺氧合撤机的病例。

方法

我们报告了一例患有急性重症心肌炎导致急性心力衰竭的青少年患者,该患者接受了静脉-动脉体外膜肺氧合、主动脉内球囊泵和肺动脉漂浮导管血流动力学监测。

结果

成功证明在泵控逆行试验关闭前后进行肺动脉漂浮导管血流动力学监测可预测拔管成功。患者成功撤掉了体外膜肺氧合、主动脉内球囊泵和肺动脉漂浮导管。其心功能逐渐恢复,并出院。

结论

肺动脉漂浮导管血流动力学监测与泵控逆行试验关闭相结合可增加静脉-动脉体外膜肺氧合成功拔管的可能性。

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