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股神经麻痹:体外膜肺氧合治疗后发生:病例报告。

Femoral neuropathy following venoarterial-extracorporeal membrane oxygenation therapy: a case report.

机构信息

Division of Cardiology, Department of Internal Medicine, Gachon University Gil Medical Center, 1198 Guwol-dong, Namdong-gu, 405-760, Incheon, Republic of Korea.

Intensive Care Unit, Department of Nursing, Gachon University Gil Medical Center, Incheon, Republic of Korea.

出版信息

BMC Cardiovasc Disord. 2020 Aug 27;20(1):393. doi: 10.1186/s12872-020-01675-y.

Abstract

BACKGROUND

Although life-threatening complications of extracorporeal membrane oxygenation (ECMO) are well described, non-life threatening complications are less known. Herein, we report a case of femoral neuropathy (FN) due to nerve compression caused by cannula compression and deep vein thrombosis (DVT) after successful ECMO therapy, which seriously undermined one's quality of life.

CASE PRESENTATION

A 70-year old male presented to the emergency department for chest pain. The patient had cardiac arrest before percutaneous coronary intervention (PCI) and was inserted with ECMO. Although he was successfully weaned from ECMO 4 days after PCI, he consistently complained swelling, abnormal sensation, and weakness in his right lower extremity, where the cannulas were inserted. Imaging studies showed deep vein thrombosis (DVT) in his right leg, which was further treated with anticoagulants. Symptoms, however, remained after the regression of DVT. Nerve conduction study revealed femoral neuropathy, which may have been caused by ECMO cannula compression and tissue swelling.

CONCLUSION

The current case proposes that non-life threatening complications of ECMO therapy can seriously affect quality of life. Venous drainage distant from the arterial cannula may prevent such complications.

摘要

背景

体外膜肺氧合(ECMO)虽已明确其危及生命的并发症,但非危及生命的并发症却知之甚少。本文报告了一例 ECMO 治疗成功后因导管压迫和深静脉血栓形成(DVT)导致股神经受压和股神经病变(FN)的病例,严重影响了患者的生活质量。

病例介绍

一名 70 岁男性因胸痛就诊于急诊科。在经皮冠状动脉介入治疗(PCI)前患者发生心脏骤停,并置入 ECMO。尽管患者在 PCI 后 4 天成功脱机 ECMO,但他持续抱怨右侧下肢(导管插入部位)肿胀、感觉异常和无力。影像学检查显示右侧下肢深静脉血栓形成(DVT),进一步给予抗凝治疗。DVT 消退后症状仍存在。神经传导研究显示股神经病变,可能由 ECMO 导管压迫和组织肿胀引起。

结论

本病例提出,ECMO 治疗的非危及生命的并发症可严重影响生活质量。远离动脉导管的静脉引流可能预防此类并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4440/7457300/ec6a893c4ef9/12872_2020_1675_Fig1_HTML.jpg

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