院外心脏骤停在难治性室颤的体外心肺复苏期间采用院前双序贯体外除颤治疗——一例病例报告
Out-of-hospital cardiac arrest treated with prehospital double sequential external defibrillation during eCPR in refractory VF - a case report.
作者信息
Katzenschlager Stephan, Heck Raphael, Popp Erik, Weilbacher Frank, Weigand Markus A, Eisner Christoph, Neuhaus Christopher
机构信息
Heidelberg University, Medical Faculty Heidelberg, Department of Anesthesiology, Im Neuenheimer Feld 420, Heidelberg, 69120, Germany.
出版信息
Int J Emerg Med. 2023 Oct 12;16(1):71. doi: 10.1186/s12245-023-00546-5.
BACKGROUND
Double sequential external defibrillation (DSED) has demonstrated increased survival with good neurological outcome in a recent randomized controlled trial. DSED has not been studied in patients with extracorporeal cardiopulmonary resuscitation (eCPR).
CASE
We present the first case of prehospital eCPR with ongoing refractory ventricular fibrillation (VF), terminated by DSED. After six shocks, return of spontaneous circulation was initially achieved; however, the patient went into recurrent VF. ECPR was performed prehospital, with VF still refractory after three more shocks. DSED successfully terminated VF and showed a further increase in etCO and near-infrared spectroscopy cerebral oximetry values.
CONCLUSION
DSED can be a sufficient strategy for patients in refractory VF while on eCPR and should be evaluated in further studies.
背景
在最近一项随机对照试验中，双重序贯体外除颤（DSED）已证明可提高生存率并改善神经功能预后。尚未在体外心肺复苏（eCPR）患者中对DSED进行研究。
病例
我们报告了首例院外eCPR合并持续性难治性室颤（VF）的病例，该病例通过DSED终止了室颤。经过6次电击后，最初实现了自主循环恢复；然而，患者再次发生室颤。在院外进行了eCPR，又经过3次电击后室颤仍为难治性。DSED成功终止了室颤，并显示呼气末二氧化碳分压（etCO）和近红外光谱脑氧饱和度值进一步升高。
结论
对于接受eCPR的难治性室颤患者，DSED可能是一种有效的策略，应在进一步研究中进行评估。
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