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病例报告:俯卧位改善主动脉夹层术后严重低氧血症

Case report: Prone positioning in the improvement of severe post-operative hypoxia following aortic dissection.

作者信息

Wang Yun, Cheng Xuping, Jiang Xuandong, Chen Lijun

机构信息

Intensive Care Unit, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, Zhejiang, China.

Cardiac Surgery, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, Zhejiang, China.

出版信息

Front Med (Lausanne). 2024 May 21;11:1379128. doi: 10.3389/fmed.2024.1379128. eCollection 2024.

Abstract

Postoperative hypoxemia after aortic dissection surgery presents a considerable clinical challenge, and acute respiratory distress syndrome (ARDS) is a common etiology. Prone positioning treatment has emerged as a potential intervention for improving respiratory function in this context. We report the case of a 27-year-old male who developed severe hypoxemia complicated by pulmonary embolism after aortic dissection surgery. He was diagnosed with postoperative hypoxemia combined with pulmonary embolism following aortic dissection. His respiratory status continued to deteriorate despite receiving standard postoperative care, thereby necessitating an alternative approach. Implementation of prone positioning treatment led to a substantial amelioration in his oxygenation and overall respiratory health, with a consistent hemodynamic state observed throughout the treatment. This technique resulted in significant relief in symptoms and improvement in respiratory parameters, facilitating successful extubation and, ultimately, discharge. This case underlines the possible efficacy of prone positioning therapy in managing severe hypoxia complicated by pulmonary embolism following aortic dissection surgery, warranting more thorough research to explore the potential of this treatment modality.

摘要

主动脉夹层手术后的术后低氧血症是一个重大的临床挑战,急性呼吸窘迫综合征(ARDS)是常见病因。在这种情况下,俯卧位治疗已成为改善呼吸功能的一种潜在干预措施。我们报告一例27岁男性患者,其在主动脉夹层手术后发生严重低氧血症并伴有肺栓塞。他被诊断为主动脉夹层术后低氧血症合并肺栓塞。尽管接受了标准的术后护理,其呼吸状况仍持续恶化,因此需要采取替代方法。实施俯卧位治疗后,他的氧合和整体呼吸健康状况有了显著改善,治疗过程中血流动力学状态保持稳定。该技术使症状得到明显缓解,呼吸参数得到改善,有助于成功拔管并最终出院。该病例强调了俯卧位治疗在处理主动脉夹层手术后合并肺栓塞的严重缺氧情况时可能具有的疗效,值得进行更深入的研究以探索这种治疗方式的潜力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/be5e/11148252/a4b497b41fdb/fmed-11-1379128-g001.jpg

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