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体外膜肺氧合成功治疗宫腔镜手术后心搏骤停:病例报告。

Successful treatment of cardiac arrest following hysteroscopic surgery using extracorporeal membrane oxygenation: A case report.

机构信息

Intensive Care Unit, The Second People's Hospital of Hefei.

Intensive Care Unit, The First Affiliated Hospital of USTC, University of Science and Technology of China, Anhui, China.

出版信息

Medicine (Baltimore). 2021 Apr 16;100(15):e25519. doi: 10.1097/MD.0000000000025519.

Abstract

RATIONALE

Cardiac arrest caused by water intoxication syndrome following hysteroscopic surgery is a rare but life-threatening occurrence. Extracorporeal membrane oxygenation (ECMO) is rarely used to treat water intoxication syndrome in hysteroscopic surgery. Here, we successfully treated a patient with water intoxication syndrome following hysteroscopic surgery with ECMO.

PATIENT CONCERNS

We report a rare case of cardiac arrest during hysteroscopic surgery treated with veno-venous (VV) ECMO.

DIAGNOSIS

Water poisoning syndrome was diagnosed by electrolyte examination, the lowest value of serum sodium was 110.7 mmol/L.

INTERVENTIONS

VV-ECMO was prescribed as a measure after traditional cardiopulmonary resuscitation.

RESULTS

ECMO was successfully evacuated on day 5 and the patient was discharged on day 45.

CONCLUSION

Mastering the hysteroscopic operative techniques and using a bipolar hysteroscopic generator, isotonic fluid, perfusion pressures less than 100 mm Hg, and local anesthesia may reduce the risk of hysteroscopic water intoxication syndrome. During hysteroscopic surgery, patients may experience cardiac arrest and fatal water intoxication syndrome. Even when traditional cardiopulmonary resuscitation is successful, VV ECMO may contribute to the recovery of brain function if oxygenation is not maintained.

摘要

背景

宫腔镜手术后水中毒综合征引起的心脏骤停是一种罕见但危及生命的事件。体外膜肺氧合(ECMO)很少用于治疗宫腔镜手术中的水中毒综合征。在这里,我们成功地使用 ECMO 治疗了宫腔镜手术后水中毒综合征患者。

关注点

我们报告了一例宫腔镜手术中罕见的心脏骤停,经静脉-静脉(VV)ECMO 治疗。

诊断

通过电解质检查诊断为水中毒综合征,血清钠最低值为 110.7mmol/L。

干预措施

传统心肺复苏后采用 VV-ECMO 作为治疗措施。

结果

第 5 天 ECMO 成功撤离,第 45 天患者出院。

结论

掌握宫腔镜手术技术,使用双极宫腔镜发生器、等渗液、灌注压力低于 100mmHg 和局部麻醉,可能会降低宫腔镜水中毒综合征的风险。在宫腔镜手术中,患者可能会发生心脏骤停和致命的水中毒综合征。即使传统心肺复苏成功,如果不能维持氧合,VV-ECMO 也可能有助于恢复脑功能。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/74ca/8052025/db55da8944c8/medi-100-e25519-g001.jpg

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