Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan.
Department of Cardiology, Kawaguchi Municipal Medical Center, Kawaguchi, Saitama, Japan.
Perfusion. 2022 May;37(4):426-428. doi: 10.1177/0267659121998545. Epub 2021 Feb 26.
Acute type B aortic dissection is sometimes complicated by acute respiratory failure requiring mechanical ventilation. Herein, we describe our experience in a rare acute type B aortic dissection-associated respiratory failure case culminating in acute respiratory distress syndrome. The patient was a 45-year-old man admitted with a complaint of sudden chest pain radiating to his back. On computed tomography, an acute type B aortic dissection was diagnosed. He had no dyspnea on admission, but his respiratory function subsequently deteriorated, and severe acute respiratory distress syndrome was diagnosed on Day 4. Venovenous extracorporeal membrane oxygenation with anticoagulation plus continuous renal replacement therapy for oliguria improved the oxygenation, and the patient was weaned from the extracorporeal membrane oxygenation on Day 8. This patient fully recovered without worsening the aortic dissection, using venovenous extracorporeal membrane oxygenation with anticoagulation plus a continuous renal replacement therapy.
急性 B 型主动脉夹层有时会并发急性呼吸衰竭，需要机械通气。在此，我们描述了一例罕见的急性 B 型主动脉夹层相关呼吸衰竭病例，最终发展为急性呼吸窘迫综合征。患者为 45 岁男性，因突发胸痛放射至背部就诊。计算机断层扫描诊断为急性 B 型主动脉夹层。患者入院时无呼吸困难，但呼吸功能随后恶化，第 4 天诊断为严重急性呼吸窘迫综合征。给予抗凝的静脉-静脉体外膜肺氧合联合少尿持续肾脏替代治疗改善了氧合，第 8 天患者成功撤离体外膜肺氧合。该患者使用抗凝的静脉-静脉体外膜肺氧合联合持续肾脏替代治疗，充分恢复，主动脉夹层无恶化。
