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巴特综合征患者的冠状动脉搭桥手术——术后重症监护管理:一例病例报告

Coronary artery bypass surgery in a patient with Bartter's syndrome - postoperative critical care management: a case report.

作者信息

Protos Adam Nicholas, Jeyakumar Ashok Kumar Coimbatore, Sams Hanna, Dossabhoy Neville Rohinton, Tsiouris Athanasios

机构信息

Division of Cardiac Surgery, Department of Surgery, University of Mississippi Medical Center, 2500 N State St, Jackson, MS 39216 USA.

Division of Nephrology, Department of Medicine, University of Mississippi Medical Center, 2500 N State St, Jackson, MS 39216 USA.

出版信息

Indian J Thorac Cardiovasc Surg. 2024 May;40(3):357-360. doi: 10.1007/s12055-023-01658-6. Epub 2023 Dec 18.

Abstract

Bartter syndrome is a rare, renal tubulopathy caused by defective salt reabsorption in the thick ascending limb of the loop of Henle which results in salt wasting, hypokalemia, and metabolic disturbances. The electrolyte disturbances associated with this condition can be difficult to manage in the postoperative setting, especially in patients undergoing cardiac surgery. We report a case of a 62-year-old male with a history of diabetes, hypertension, coronary artery disease, and Bartter syndrome who underwent coronary artery bypass grafting and who developed severe lactic acidemia and severe electrolyte abnormalities postoperatively. Treatment consisted of aggressive resuscitation with crystalloid and intravenous (IV) electrolyte replacement.

摘要

巴特综合征是一种罕见的肾小管病,由髓袢升支粗段的盐重吸收缺陷引起,导致盐丢失、低钾血症和代谢紊乱。与这种情况相关的电解质紊乱在术后环境中可能难以处理,尤其是在接受心脏手术的患者中。我们报告一例62岁男性病例,该患者有糖尿病、高血压、冠状动脉疾病和巴特综合征病史,接受了冠状动脉旁路移植术,术后出现严重乳酸血症和严重电解质异常。治疗包括用晶体液积极复苏和静脉补充电解质。

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