Enomoto Yuria, Matsuda Yuko, Nagamine Yusuke, Goto Takahisa
Department of Anesthesiology and Critical Care Medicine, Yokohama City University Hospital, 3-9 Fukuura, Kanazawa-Ku, Kanagawa, 236-0004, Yokohama, Japan.
JA Clin Rep. 2023 Mar 14;9(1):14. doi: 10.1186/s40981-023-00606-y.
Hypercalcemia crisis is a rare but severe form of hypercalcemia complicated by multiple organ failure. Hypercalcemia crisis due to hyperparathyroidism is commonly caused by a parathyroid tumor, which often requires surgical resection. However, there are no clear recommendations on when the surgery should be performed.
A 64-year-old female patient developed hyperparathyroidism due to a parathyroid tumor and hypercalcemic crisis, which was complicated by severe circulatory and respiratory failure refractory to medical therapy, and an emergent surgery was planned to resect the parathyroid tumor. To prevent intraoperative circulatory and respiratory collapse, venoarterial-extra corporeal membrane oxygenation (VA-ECMO) was introduced, resulting in a safe operation and anesthetic management.
In patients with hypercalcemic crisis complicated by severe circulatory and respiratory failure, induction of prophylactic VA-ECMO was useful for safe anesthetic management. Surgical resection should be performed as soon as the diagnosis is made before VA-ECMO is required.
高钙血症危象是一种罕见但严重的高钙血症形式，常并发多器官功能衰竭。甲状旁腺功能亢进引起的高钙血症危象通常由甲状旁腺肿瘤所致，常需手术切除。然而，对于何时进行手术尚无明确建议。
一名64岁女性患者因甲状旁腺肿瘤并发甲状旁腺功能亢进及高钙血症危象，伴有严重循环和呼吸衰竭，药物治疗无效，遂计划紧急手术切除甲状旁腺肿瘤。为防止术中循环和呼吸衰竭，采用了静脉-动脉体外膜肺氧合（VA-ECMO），实现了安全的手术和麻醉管理。
对于并发严重循环和呼吸衰竭的高钙血症危象患者，预防性应用VA-ECMO有助于安全的麻醉管理。一旦确诊，应在需要VA-ECMO之前尽快进行手术切除。
