Tada Shuhei, Kikuta Shota, Matsuyama Shigenari, Ishihara Satoshi
Anesthesia and Critical Care, Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu, JPN.
Emergency and Critical Care Medicine, Hyogo Emergency Medical Center, Kobe, JPN.
Cureus. 2024 Aug 7;16(8):e66403. doi: 10.7759/cureus.66403. eCollection 2024 Aug.
A man in his 70s suffered cardiac arrest, and his family initiated cardiopulmonary resuscitation after placing an emergency call. The initial waveform of the automated external defibrillator performed by emergency medical technicians revealed ventricular fibrillation. The patient received cardiovascular life support, including direct current countershock, and was transported to the hospital. Upon arrival, he underwent extracorporeal cardiopulmonary resuscitation using an automated chest compression device. Additionally, an intra-aortic balloon pumping was introduced after coronary angiography and percutaneous coronary intervention. Plain computed tomography images revealed leakage of the contrast medium used during coronary angiography in the bilateral renal pelvis and perirenal area as well as bladder retention. Furthermore, a urine test revealed gross hematuria. There were no findings of prostatic hypertrophy or urinary tract disease. Based on the patient's clinical course, injury caused by chest compression was the most likely etiology of urinary tract injury, which must be considered in such patients. The patient was discharged with cerebral performance category 1, without any complication except urinary tract.
一名70多岁的男性发生心脏骤停，其家人拨打急救电话后进行了心肺复苏。急救医疗技术人员使用自动体外除颤器的初始波形显示为心室颤动。患者接受了包括直流电除颤在内的心血管生命支持，并被送往医院。到达医院后，他使用自动胸外按压装置进行了体外心肺复苏。此外，在冠状动脉造影和经皮冠状动脉介入治疗后进行了主动脉内球囊反搏。普通计算机断层扫描图像显示，冠状动脉造影期间使用的造影剂在双侧肾盂和肾周区域以及膀胱潴留处渗漏。此外，尿检显示肉眼血尿。未发现前列腺肥大或泌尿系统疾病。根据患者的临床病程，胸部按压造成的损伤最有可能是泌尿系统损伤的病因，对此类患者必须予以考虑。患者出院时脑功能分类为1级，除泌尿系统外无任何并发症。
