Service d'Anesthésie-Réanimation Chirurgicale, CHU Henri Mondor, Assistance Publique des Hôpitaux de Paris, Créteil, France; U955-IMRB, Equipe 03 "Stratégies pharmacologiques et thérapeutiques expérimentales des insuffisances cardiaques et coronaires," Inserm, UPEC, Ecole Nationale Vétérinaire d'Alfort, Maisons-Alfort, France.
Service d'Anesthésie-Réanimation Chirurgicale, CHU Henri Mondor, Assistance Publique des Hôpitaux de Paris, Créteil, France.
Ann Thorac Surg. 2020 Mar;109(3):e161-e162. doi: 10.1016/j.athoracsur.2019.05.093. Epub 2019 Jul 27.
Sickle cell disease (SCD) is among the most common genetic diseases, with a recent increase in life expectancy. Patients may therefore need similar surgical procedures as does the general population, including cardiac surgery. Cardiopulmonary bypass is a homeostasis challenge for SCD patients, with high risk of vasoocclusive crisis. In the most severe cases of cardiogenic shock, venoarterial extracorporeal membrane oxygenation (VA-ECMO) may be required, with prolonged exposure to extreme nonphysiological conditions. We report a case of postcardiotomy shock in an SCD patient successfully managed with VA-ECMO. This highlights that SCD should not be a counterindication to VA-ECMO, pending multidisciplinary management.
镰状细胞病 (SCD) 是最常见的遗传疾病之一，近年来患者的预期寿命有所延长。因此，他们可能需要与普通人群类似的手术，包括心脏手术。体外循环对 SCD 患者是一种体内平衡的挑战，发生血管阻塞性危象的风险很高。在心肌梗死性休克最严重的情况下，可能需要使用静脉-动脉体外膜肺氧合 (VA-ECMO)，并长时间暴露于极端非生理条件下。我们报告了一例 SCD 患者心脏手术后休克成功接受 VA-ECMO 治疗的病例。这表明，在多学科管理的前提下，SCD 不应成为 VA-ECMO 的禁忌症。
