1st Department of Surgery, General University Hospital, 128 08 Prague, Czech Republic.
1st Medical Faculty, Charles University, 128 00 Prague, Czech Republic.
Medicina (Kaunas). 2024 Sep 9;60(9):1470. doi: 10.3390/medicina60091470.
: Liver injury is a rare complication of cardiopulmonary resuscitation. Correct and early diagnosis and treatment are essential. The clinical signs of injury may be masked by the cardiac arrest. We present a single-centre retrospective observational study of traumatic liver injury after cardiopulmonary resuscitation. : A retrospective analysis of the patients treated for liver injury after cardiopulmonary resuscitation was conducted. Demographic data, the cause of resuscitation, the duration of restoration of spontaneous circulation (ROSC), and the surgical approach were analysed. : We have treated nine patients with severe liver injury after cardiopulmonary resuscitation. The diagnosis was made on the basis of cardiopulmonary instability, a fall in the erythrocyte count in eight cases, and was confirmed by CT or ultrasound examination. The last one was diagnosed accidentally on MR. Surgery, in cases of unstable patients, was followed immediately after a diagnosis. We combined liver sutures and intra-abdominal packing with a planned second-look surgery. Five of the nine patients survived. : Liver injury after cardiopulmonary resuscitation is rare and is associated with high mortality. The recurrence of cardiopulmonary instability and/or a low or falling red blood cell count are the main signs of this injury. Bedside ultrasound and CT scans are the most important methods to confirm the diagnosis. The rule of surgical repair is the same as in all liver injuries, regardless of aetiology. The key factors for survival include early diagnosis, together with the length of restoration of spontaneous circulation (ROSC).
肝脏损伤是心肺复苏后罕见的并发症。正确和早期的诊断和治疗至关重要。损伤的临床症状可能会被心脏骤停所掩盖。我们报告了一例心肺复苏后创伤性肝损伤的单中心回顾性观察研究。
对心肺复苏后肝损伤患者进行了回顾性分析。分析了人口统计学数据、复苏原因、自主循环恢复(ROSC)时间和手术方法。
我们治疗了 9 例心肺复苏后严重肝损伤患者。根据心肺不稳定、8 例红细胞计数下降的情况做出诊断,并通过 CT 或超声检查得到证实。最后一例是在磁共振检查中意外诊断的。对于不稳定的患者,在诊断后立即进行手术。我们采用肝缝合和腹腔填塞联合计划二次探查手术。9 例患者中有 5 例存活。
心肺复苏后肝脏损伤罕见,死亡率高。心肺不稳定的复发和/或红细胞计数低或下降是这种损伤的主要征象。床边超声和 CT 扫描是确认诊断最重要的方法。手术修复的原则与所有肝损伤相同,与病因无关。存活的关键因素包括早期诊断,以及自主循环恢复(ROSC)的时间。