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乙醇硬化疗法治疗血管畸形所致心肺骤停的挽救:单中心临床经验及文献综述

Salvage of cardiopulmonary collapse caused by ethanol sclerotherapy for vascular malformations: clinical experience at a single center and literature review.

作者信息

Su Lixin, Zhao Yan, Shen Yuchen, Fan Xindong, Wang Zhenfeng, Wang Deming, Li Qingyang

机构信息

Department of Vascular Anomaly, Fengcheng Hospital of Fengxian District, Shanghai, China.

Department of Interventional Therapy, Multidisciplinary Team of Vascular Anomalies, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, Shanghai, China.

出版信息

Front Cardiovasc Med. 2024 Nov 20;11:1439839. doi: 10.3389/fcvm.2024.1439839. eCollection 2024.

Abstract

OBJECTIVE

This review aims to summarize the salvage experience of cardiopulmonary collapse occurring as a result of absolute ethanol sclerotherapy for vascular malformations.

METHODS

In total, we reviewed three cases of cardiopulmonary collapse induced by ethanol sclerotherapy for vascular malformations and described the details of the salvage procedure. Saturation of pulse oxygen (SpO), end-tidal CO, and invasive arterial pressure were the routine monitors for ethanol injection patients. Cardiopulmonary resuscitation, epinephrine, norepinephrine, and deoxyepinephrine were mainly used to correct circulation parameters. Manually ventilated via endotracheal intubation with 100% O, increased respiratory rate were mainly used to correct Respiratory parameters.

RESULTS

All three cases were successfully salvaged without major complications. When cardiopulmonary collapse occurred, manual ventilation via endotracheal intubation with 100% O, increased ventilation frequency and external cardiac compression were the emergency treatments. Epinephrine, norepinephrine, deoxyepinephrine infusion solely or combined were crucial to maintaining the basic vital signs.

CONCLUSION

Despite the severity of cardiopulmonary collapse caused by ethanol sclerotherapy, it can be detected by close observation and reversed with timely treatment.

摘要

目的

本综述旨在总结因绝对乙醇硬化治疗血管畸形而发生心肺骤停的抢救经验。

方法

我们共回顾了3例因乙醇硬化治疗血管畸形导致心肺骤停的病例,并描述了抢救过程的细节。脉搏血氧饱和度(SpO)、呼气末二氧化碳分压(EtCO₂)和有创动脉压是乙醇注射患者的常规监测指标。心肺复苏、肾上腺素、去甲肾上腺素和甲氧明主要用于纠正循环参数。通过气管插管进行100%氧气手动通气、增加呼吸频率主要用于纠正呼吸参数。

结果

所有3例均成功抢救,无严重并发症。发生心肺骤停时,通过气管插管进行100%氧气手动通气、增加通气频率和胸外心脏按压是紧急处理措施。单独或联合输注肾上腺素、去甲肾上腺素、甲氧明对于维持基本生命体征至关重要。

结论

尽管乙醇硬化治疗引起的心肺骤停严重,但通过密切观察可被发现,并通过及时治疗得以逆转。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cfb4/11614990/3917710a409a/fcvm-11-1439839-g001.jpg

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