Demas C, Flancbaum L, Scott G, Trooskin S Z
Division of Trauma Surgery, UMDNJ-Robert Wood Johnson Medical School, New Brunswick 08903.
Am J Emerg Med. 1987 Nov;5(6):499-502. doi: 10.1016/0735-6757(87)90170-7.
The management of patients with post-traumatic myocardial contusion requires close electrocardiographic and hemodynamic monitoring. When complications such as cardiogenic shock occur, aggressive treatment using Swan-Ganz catheterization for monitoring of intravascular volume and cardiac inotropic support are necessary. Failure to restore hemodynamic stability using these measures is an indication for the use of intra-aortic balloon pump counterpulsation. A case of successful management of a patient with post-traumatic myocardial contusion complicated by refractory cardiogenic shock using intra-aortic balloon pump counterpulsation is presented. Use of the intra-aortic balloon pump improved cardiac output, eventually resulting in hemodynamic stabilization.
创伤后心肌挫伤患者的管理需要密切的心电图和血流动力学监测。当发生心源性休克等并发症时,必须积极采用Swan-Ganz导管插入术监测血管内容量并给予心脏正性肌力支持治疗。若采用这些措施未能恢复血流动力学稳定,则表明需要使用主动脉内球囊反搏。本文介绍了一例使用主动脉内球囊反搏成功治疗创伤后心肌挫伤并发难治性心源性休克患者的病例。主动脉内球囊反搏的使用改善了心输出量,最终实现了血流动力学稳定。