Hoffer Megan, Aziz Salim, Boniface Keith, Aziz Jenna E, Pourmand Ali
Department of Emergency Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
Division of Cardiac Surgery, George Washington University Hospital, Washington, DC, USA.
Clin Exp Emerg Med. 2024 Mar;11(1):100-105. doi: 10.15441/ceem.23.084. Epub 2023 Nov 5.
Extracorporeal membrane oxygenation (ECMO) has been increasingly employed in the emergency department for patients with a potentially reversible cause of cardiac arrest. We present the case of a young female patient with an in-hospital cardiac arrest who was found to have severe right heart strain on point-of-care ultrasound (POCUS), suggesting a massive pulmonary embolism. Rapid bedside diagnosis using ultrasound expedited bedside cannulation and initiation of ECMO as a bridge to surgical thrombectomy, and ultimately the patient survived with full neurologic function. With its ready availability and increasing acceptance by consultants, POCUS should be incorporated into cardiac arrest algorithms as the standard of care to rule in thrombotic and obstructive causes of cardiac arrest.
体外膜肺氧合（ECMO）在急诊科越来越多地用于心脏骤停可能具有可逆病因的患者。我们报告了一例年轻女性患者，她在医院内发生心脏骤停，经床旁即时超声（POCUS）检查发现有严重的右心劳损，提示大面积肺栓塞。使用超声进行快速床旁诊断加快了床旁插管和启动ECMO作为手术取栓桥接治疗的速度，最终患者存活且神经功能完全恢复。鉴于其随时可用且越来越被会诊医生所接受，POCUS应作为心脏骤停血栓形成和梗阻性病因诊断的标准护理措施纳入心脏骤停诊疗方案。
