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创伤中的拉撒路现象。

Lazarus phenomenon in trauma.

作者信息

Mahon Timothy, Kalakoti Piyush, Conrad Steven A, Samra Navdeep S, Edens Mary Ann

机构信息

Department of Emergency Medicine, Louisiana State University Health Sciences Center, Shreveport, LA, United States.

Department of Neurosurgery, Louisiana State University Health Sciences Center, Shreveport, LA, United States.

出版信息

Trauma Case Rep. 2020 Jan 8;25:100280. doi: 10.1016/j.tcr.2020.100280. eCollection 2020 Feb.

Abstract

Lazarus phenomenon embodies auto-resuscitation, aka the return of spontaneous circulation following termination of cardiopulmonary resuscitation. Limited or no literature exists that describes auto-resuscitation in trauma. In the current report, we describe a case of an older woman that presented with poly-traumatic injuries following a motor vehicle collision. The aggressive resuscitation efforts failed, and the patient witnessed a pulseless electrical activity; however, nine-minutes after cessation of resuscitation efforts, the patient experienced auto-resuscitation. In addition to the sequel of events following the presentation, the report highlights the management dilemma and ethical implications relating to the observation period for auto-resuscitation in cases of donation after circulatory death, where the urgency to harvest the organs to ensure maximum viability is in direct opposition to ensuring enough time has elapsed to rule out auto-resuscitation. Guidelines on an appropriate period for observation in auto-resuscitation patients queued for organ donation are warranted, keeping in lieu viability of organs following death.

摘要

拉撒路现象体现了自动复苏,即心肺复苏终止后自主循环恢复。关于创伤中自动复苏的文献有限或几乎没有。在本报告中,我们描述了一名老年女性病例,她在机动车碰撞后出现多处创伤性损伤。积极的复苏努力失败了,患者出现了无脉电活动;然而,在停止复苏努力九分钟后,患者经历了自动复苏。除了呈现事件的后续情况外,该报告还强调了在循环死亡后捐赠情况下自动复苏观察期的管理困境和伦理问题,即获取器官以确保最大存活能力的紧迫性与确保有足够时间排除自动复苏直接相悖。鉴于死后器官的存活能力,有必要制定关于排队等待器官捐赠的自动复苏患者适当观察期的指南。

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本文引用的文献

2
A systematic review of autoresuscitation after cardiac arrest.心脏骤停后自主复苏的系统评价。
Crit Care Med. 2010 May;38(5):1246-53. doi: 10.1097/CCM.0b013e3181d8caaa.
7
The Lazarus phenomenon revisited.再探拉撒路现象。
Anesthesiology. 1993 May;78(5):991. doi: 10.1097/00000542-199305000-00030.
8
Statement on non-heart-beating donor programs.
Transplant Proc. 1995 Oct;27(5):2965.
10
Recovery after discontinued cardiopulmonary resuscitation.停止心肺复苏后的恢复情况。
Lancet. 1982 Jan 9;1(8263):106-7. doi: 10.1016/s0140-6736(82)90242-2.

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