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成功管理恶性高热易感患者低温心肺转流

Successful management of hypothermic cardiopulmonary bypass in a malignant hyperthermia susceptible patient.

机构信息

Department of Anesthesiology and Perioperative Medicine, Division of Cardiovascular Anesthesia, Augusta University, Augusta, GA, US.

出版信息

Ann Card Anaesth. 2020 Jul-Sep;23(3):367-371. doi: 10.4103/aca.ACA_245_18.

Abstract

Malignant hyperthermia (MH) is a potentially lethal reaction in those that are genetically predisposed, frequently triggered by inhaled anesthetics. MH is often difficult to diagnose because it is accompanied by signs and symptoms that are shared with other disorders. The diagnosis is further obscured in cardiac surgical patients, as the signs of MH can be masked by the cardiopulmonary bypass circuit (CPB) and the use of induced hypothermia. In this case-report, we describe the successful anesthetic management of a 65-year-old MH-susceptible female, confirmed via caffeine halothane contracture test, with aortic regurgitation and ascending aortic dilatation who underwent a Bentall procedure. We have also identified certain key measures for the safe anesthetic management of these patients.

摘要

恶性高热(MH)是一种具有潜在致命性的遗传性疾病,常由吸入性麻醉剂引发。由于 MH 常伴有与其他疾病相同的体征和症状,因此其诊断较为困难。对于心脏外科患者,这种情况则更为复杂,因为 MH 的体征可能会被体外循环(CPB)和诱导性低温所掩盖。在本病例报告中,我们描述了一例经咖啡因氟烷收缩试验证实的、易感恶性高热的 65 岁女性患者的麻醉管理,该患者患有主动脉瓣关闭不全和升主动脉扩张,接受了 Bentall 手术。我们还确定了某些用于这些患者安全麻醉管理的关键措施。

相似文献

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1
Hypothermic versus normothermic cardiopulmonary bypass in patients with valvular heart disease.瓣膜性心脏病患者的低温与常温体外循环
J Cardiothorac Vasc Anesth. 2014 Apr;28(2):295-300. doi: 10.1053/j.jvca.2013.03.009. Epub 2013 Aug 17.
7
Malignant hyperthermia and cardiac surgery.恶性高热与心脏手术
J Cardiothorac Vasc Anesth. 2009 Feb;23(1):134-5. doi: 10.1053/j.jvca.2007.11.011. Epub 2008 Mar 14.
8
Malignant hyperthermia.恶性高热
Orphanet J Rare Dis. 2007 Apr 24;2:21. doi: 10.1186/1750-1172-2-21.

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