Ahmed Mohamed, Habis Saba, Mahmoud Ahmed, Rutland Cedric, Saeed Rasha
Surgery, Riverside Community Hospital / Envision Healthcare, Riverside, USA.
Internal Medicine, Riverside Community Hospital / Hospital Corporation of America, Riverside, USA.
Cureus. 2018 Nov 30;10(11):e3665. doi: 10.7759/cureus.3665.
Distributive (vasodilatory) shock is common in patients admitted to the intensive care unit (ICU). Treating distributive shock presents a challenge, especially if a patient is tachyphylactic to commonly used vasopressors. This case report illustrates the use of a newly approved vasopressor in a patient with vasodilatory shock resulting from a motor vehicle injury. A 56-year-old man was brought to our emergency department (ED) hemodynamically unstable requiring aggressive resuscitation. The results of his evaluation were consistent with multisystem trauma for which he required intubation on arrival, and he received multiple units of blood and blood product via transfusion. The patient's condition declined despite receiving multiple vasopressors in the ICU. A few days after admission, the patient developed ischemic bowel requiring surgical resection. While his chance of survival was believed to be dismal, the use of angiotensin II (ATII) as a last resort proved to be helpful.
分布性（血管扩张性）休克在入住重症监护病房（ICU）的患者中很常见。治疗分布性休克是一项挑战，尤其是当患者对常用血管升压药产生快速耐受性时。本病例报告说明了一种新批准的血管升压药在一名因机动车损伤导致血管扩张性休克患者中的应用。一名56岁男性被送往我们的急诊科（ED），血流动力学不稳定，需要积极复苏。他的评估结果与多系统创伤一致，入院时需要插管，并且通过输血接受了多个单位的血液和血液制品。尽管在ICU中接受了多种血管升压药治疗，患者的病情仍在恶化。入院几天后，患者出现缺血性肠病，需要手术切除。虽然他的生存机会被认为渺茫，但作为最后手段使用血管紧张素II（ATII）被证明是有帮助的。
