Department of Cardiac Anesthesia and Intensive Care Unit, Cardiac Surgery, Ospedale Dell'Angelo, Venice Mestre, Italy.
Department of Neurosciences, Institute of Human Anatomy, University of Padova, Padua, Italy.
Ann Card Anaesth. 2024 Oct 1;27(4):344-348. doi: 10.4103/aca.aca_4_24. Epub 2024 Aug 28.
We report a 55-year-old men patient with a primitive central nervous system non-Hodgkin lymphoma B cell (LNH PNSLC), treated with chemotherapy rituximab, methotrexate, and ibrutinib (first treatment) who developed a refractory ventricular arrhythmic storm two hours after the ibrutinib intake. Indeed, ibrutinib could be associated with severe and occasionally fatal cardiac events. The swift emergence of a ventricular electrical storm with cardiac arrest demanded the prompt initiation of veno-arterial extracorporeal membrane oxygenation to effectively navigate this critically ill patient toward recovery. This intervention was deemed imperative, given the absence of any available antidote for the effects of ibrutinib. Veno-arterial extracorporeal membrane oxygenation proved successful in rescuing this patient, resulting in a complete neurological recovery. Consequently, he was able to resume his chemotherapy treatment.
我们报告了一例 55 岁男性患者，患有原始中枢神经系统非霍奇金淋巴瘤 B 细胞（LNH PNSLC），接受利妥昔单抗、甲氨蝶呤和伊布替尼化疗（首次治疗），在伊布替尼摄入后两小时发生难治性室性心律失常风暴。事实上，伊布替尼可能与严重且偶尔致命的心脏事件相关。室性电风暴迅速出现并导致心脏骤停，这要求迅速启动静脉-动脉体外膜肺氧合，以有效地将这位重症患者从疾病中挽救回来。鉴于没有任何可用的伊布替尼解毒剂，这种干预措施是必要的。静脉-动脉体外膜肺氧合成功地抢救了这名患者，使其完全恢复了神经功能。因此，他能够继续接受化疗治疗。
