Zhao Manxu, D'Attellis Nicola, Emerson Dominic, Moll Vanessa, Esmailian Fardad
Department of Anesthesiology, Cedars-Sinai Medical Center, Los Angeles, CA, United States.
Department of Cardiac Surgery, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States.
Front Surg. 2022 Feb 28;9:812288. doi: 10.3389/fsurg.2022.812288. eCollection 2022.
We describe a case of spontaneous retroperitoneal hematoma leading to abdominal compartment syndrome and organ failure during a complicated orthotopic heart transplantation in a patient previously on mechanical circulatory support. After the patient had been weaned of cardiopulmonary bypass, the patient suddenly became hemodynamically unstable despite good LV and RV function. While the patient was resuscitated, high intra-abdominal pressures were noted on a novel monitor measuring real-time intra-abdominal pressures and urinary output. The early detection of high intra-abdominal pressures led to a swift decompressive laparotomy with the detection of retroperitoneal hematoma and subsequent hemodynamic stabilization.
我们描述了一例在先前接受机械循环支持的患者进行复杂原位心脏移植过程中，自发性腹膜后血肿导致腹腔间隔室综合征和器官衰竭的病例。患者脱离体外循环后，尽管左心室和右心室功能良好，但突然出现血流动力学不稳定。在对患者进行复苏时，通过一种新型的实时测量腹腔内压力和尿量的监测仪发现腹腔内压力升高。腹腔内高压的早期发现促使迅速进行减压剖腹手术，术中发现腹膜后血肿，随后血流动力学得以稳定。
