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体外生命支持在创伤性血心包中的作用：一家一级创伤中心的回顾

Role of extracorporeal life support for traumatic hemopericardium: A single level I trauma center review.

作者信息

Kim Eunji, Song Seunghwan, Kim Seon Hee, Lee Na Hyeon, Lee Soojin

机构信息

Department of Thoracic and Cardiovascular Surgery, Pusan National University School of Medicine, BioMedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea.

Department of Thoracic and Cardiovascular Surgery, Pusan National University School of Medicine, BioMedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea.

出版信息

Injury. 2024 Jan;55(1):111193. doi: 10.1016/j.injury.2023.111193. Epub 2023 Nov 9.

DOI:10.1016/j.injury.2023.111193
PMID:37985267
Abstract

BACKGROUND

Traumatic hemopericardium may lead to cardiac tamponade, arrhythmia, arrest, or death and requires emergency surgery. We reviewed cases of traumatic hemopericardium in our center and the role of extracorporeal life support in these cases.

METHODS

From November 2011 to January 2022, 28 patients with significant hemopericardium and suspected cardiac injury were enrolled. In our center, surgery is the primary treatment of choice; however, if the patient is in an unstable condition, extracorporeal life support is administered in the emergency room prior to surgery.

RESULTS

Preoperative extracorporeal life support was applied to 10 patients (36 %). Two patients (20 %) were converted from extracorporeal life support to cardiopulmonary bypass during operation. After surgery, 2 patients (20 %) needed postoperative extracorporeal membrane oxygenation support. Overall, 21 patients (75 %) survived; of these, 6 (29 %) received extracorporeal life support. Meanwhile, 7 patients (25 %) died; of these, 4 patients (57 %) received extracorporeal life support.

CONCLUSION

Resuscitation method is the most crucial survival strategy in patients with severe chest trauma. Extracorporeal life support in cases of traumatic hemopericardium may be beneficial and efficient in stabilizing patients prior to surgery.

摘要

背景

创伤性血心包可导致心脏压塞、心律失常、心脏骤停或死亡，需要紧急手术。我们回顾了本中心创伤性血心包的病例以及体外生命支持在这些病例中的作用。

方法

2011年11月至2022年1月，纳入28例有大量血心包且疑似心脏损伤的患者。在本中心，手术是主要的治疗选择；然而，如果患者病情不稳定，则在手术前于急诊室给予体外生命支持。

结果

10例患者（36%）术前应用了体外生命支持。2例患者（20%）在手术期间从体外生命支持转为体外循环。术后，2例患者（20%）需要术后体外膜肺氧合支持。总体而言，21例患者（75%）存活；其中6例（29%）接受了体外生命支持。同时，7例患者（25%）死亡；其中4例（57%）接受了体外生命支持。

结论

复苏方法是严重胸部创伤患者最关键的生存策略。创伤性血心包病例中的体外生命支持在术前稳定患者病情方面可能是有益且有效的。

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