Ogiwara Shigetoshi, Wada Soichiro, Sai Shuji, Tamura Takuya
Department of Pediatric Critical Care, Teine Keijinkai Hospital, Sapporo, JPN.
Department of Pediatrics, Teine Keijinkai Hospital, Sapporo, JPN.
Cureus. 2024 Mar 3;16(3):e55429. doi: 10.7759/cureus.55429. eCollection 2024 Mar.
Anorexia nervosa (AN) is a psychiatric disorder with metabolic abnormalities. Prolonged cardiopulmonary resuscitation (CPR) is predicted to result in death and poor neurological outcomes. This report describes the case of a patient with AN who had an unexpectedly favorable outcome after prolonged CPR. A 12-year-old female with AN presented to the emergency department, requiring intubation due to worsening consciousness and respiratory distress. Refractory hypotension led to cardiac arrest. After 135 minutes of CPR, venoarterial extracorporeal membrane oxygenation (EMCO) was started, and the patient was treated for post-resuscitation management, refeeding syndrome, and sepsis. The cardiac function gradually improved, the patient was weaned from EMCO eight days after admission, and the patient was extubated 30 days after admission. The patient maintained a good central nervous system function. AN patients tend to be youngsters and have a lower metabolism, which may be associated with a favorable neurological prognosis after prolonged CPR.
神经性厌食症（AN）是一种伴有代谢异常的精神疾病。长时间心肺复苏（CPR）预计会导致死亡和不良的神经学预后。本报告描述了一名患有AN的患者在长时间CPR后取得意外良好预后的病例。一名12岁患有AN的女性因意识恶化和呼吸窘迫被送往急诊科，需要进行插管。难治性低血压导致心脏骤停。在进行了135分钟的CPR后，开始进行静脉-动脉体外膜肺氧合（EMCO）治疗，该患者接受了复苏后管理、再喂养综合征和败血症的治疗。心脏功能逐渐改善，患者在入院八天后脱离了EMCO，在入院30天后拔管。患者维持了良好的中枢神经系统功能。AN患者往往是年轻人且新陈代谢较低，这可能与长时间CPR后良好的神经学预后有关。
