钝性心脏损伤与术中低氧血症

Blunt cardiac injury and intraoperative hypoxaemia.

作者信息

Kantor G, Devitt J H

机构信息

Department of Anaesthesia, Sunnybrook Health Science Centre, University of Toronto, Ontario.

出版信息

Can J Anaesth. 1993 Jun;40(6):515-7. doi: 10.1007/BF03009733.

DOI:10.1007/BF03009733

PMID:8403115

Abstract

A 28-yr-old man sustained blunt chest trauma in a motor vehicle accident. Severe intraoperative hypoxaemia occurred, unresponsive to oxygen and positive expiratory pressure therapy. Trans-oesophageal echocardiography revealed myocardial contusion and tricuspid valve rupture. Dobutamine improved left ventricular function and ejection fraction resulting in an immediate improvement in arterial oxygenation and saturation. Tricuspid injury and the diagnosis of myocardial contusion are discussed. The case highlights the importance of a non-pulmonary mechanism of hypoxaemia.

摘要

一名28岁男性在机动车事故中胸部受到钝性创伤。术中出现严重低氧血症，对吸氧和呼气末正压通气治疗无反应。经食管超声心动图显示心肌挫伤和三尖瓣破裂。多巴酚丁胺改善了左心室功能和射血分数，使动脉氧合和饱和度立即得到改善。本文讨论了三尖瓣损伤及心肌挫伤的诊断。该病例突出了低氧血症非肺部机制的重要性。