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rt-PA 输注后血管性水肿导致气道紧急情况:新鲜冷冻血浆抢救治疗的病例报告。

Angioedema after rt-PA infusion led to airway emergency: a case report of rescue treatment with fresh frozen plasma.

机构信息

Ospedale Maggiore, Intensive Care and Prehospital Emergency Service, Department of Anesthesia, Bologna, Italy.

Ospedale Maggiore, Intensive Care and Prehospital Emergency Service, Department of Anesthesia, Bologna, Italy.

出版信息

Braz J Anesthesiol. 2023 Mar-Apr;73(2):223-226. doi: 10.1016/j.bjane.2021.04.023. Epub 2021 Apr 28.

Abstract

The authors report the case of a 71-year-old woman presented to the Emergency Department with acute ischemic stroke. She was treated with rt-PA and interventional endovascular revascularization and developed rapidly progressing angioedema that led to emergency intubation. The standard treatment was not very effective and the swelling improved after infusion of fresh frozen plasma. Angioedema after rt-PA infusion could be a life-threatening emergency that requires quick airway management by skilled professionals. As this condition is triggered by several factors, such as unregulated histamine and bradykinin production, the traditional treatment recommended by the guidelines may not be sufficient and the use of FFP can be considered as a safe and valuable aid.

摘要

作者报告了一例 71 岁女性因急性缺血性脑卒中就诊于急诊科的病例。她接受了 rt-PA 和介入血管内再通治疗,并迅速发生进展性血管性水肿,导致紧急插管。标准治疗效果不佳,输注新鲜冷冻血浆后肿胀改善。rt-PA 输注后发生血管性水肿可能是危及生命的紧急情况,需要熟练的专业人员进行快速气道管理。由于这种情况是由多种因素引起的,如组胺和缓激肽产生不受调节,因此指南推荐的传统治疗可能不够充分,使用 FFP 可以被视为一种安全且有价值的辅助治疗。

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