Kanaya N, Nakaya J, Sumita S, Namiki A
Department of Anesthesiology, Sapporo Medical University.
Masui. 1994 Mar;43(3):400-4.
A 67-year-old man was scheduled for left upper lobectomy under epidural and general anesthesia. About 1 hour after the beginning of operation, he developed cardiac arrest due to sudden massive bleeding from the pulmonary artery. In spite of open chest cardiac massage and intravenous administration of epinephrine, we could not resuscitate him successfully. More than 30 minutes after the cardiac arrest, cardiopulmonary bypass (CPB) was started and mean arterial blood pressure was maintained at 50-60 mmHg. His pulmonary artery was repaired under CPB. One hour after CPB, the weaning from artificial circulation was attempted and the spontaneous beating was observed. However, he developed low cardiac output syndrome due to long time ischemia resulting in hemorrhagic infarction. Therefore, the intra-aortic balloon pumping was started and his hemodynamics was immediately restored. We presume that CPB is useful for intraoperative resuscitation and this gives us new application of advanced life support for the patient in whom the conventional technique is ineffective.
一名67岁男性计划在硬膜外麻醉和全身麻醉下进行左肺上叶切除术。手术开始约1小时后，他因肺动脉突然大量出血而发生心脏骤停。尽管进行了开胸心脏按压并静脉注射了肾上腺素，但我们未能成功使他复苏。心脏骤停30多分钟后，开始进行体外循环（CPB），平均动脉血压维持在50 - 60 mmHg。在CPB下对他的肺动脉进行了修复。CPB 1小时后，尝试撤离人工循环并观察到自主心跳。然而，由于长时间缺血导致出血性梗死，他出现了低心排血量综合征。因此，开始进行主动脉内球囊反搏，其血流动力学立即得到恢复。我们推测CPB对术中复苏有用，这为传统技术无效的患者提供了高级生命支持的新应用。
