[严重意外低温时体外循环复温。3例报告]
[Extracorporeal circulation for warming in severe accidental hypothermia. 3 cases].
作者信息
Demaria R, Frapier J M, Valat J, Albat B, Aymard T, Geoffroy N, Godard C, Bodino M, Rouvière P, Chaptal P A
机构信息
Service de Chirurgie thoracique et cardio-vasculaire Hôpital Amaud de Villeneuve, Montpellier.
出版信息
Presse Med. 1998 Apr 11;27(14):664-6.
BACKGROUND
Severe accidental hypothermia with central temperature below 28 degrees C can result from prolonged cold exposure and lead to a fatal outcome by spontaneous or provoked ventricular fibrillation.
CASE REPORT
Three patients were referred for central temperature below 24 degrees C. At admission, the patients had major ventricular rythm disorders (two were in a state of circulatory arrest and the third had auricular fibrillation and circulatory collapse). Emergency care associated internal warning using extracorporeal circulation via the femoro-femoral route with a centrifuge pump. Outcome was favorable in 2 cases.
DISCUSSION
Prognosis is very poor in patients who experience severe accidental hypothermia (< 28 degrees C) with circulatory collapse. Death often results from major rhythm disorders. Optimal emergency rewarming and oxygenation using extracorporeal circulatory assistance can be successful.
背景
长时间暴露于寒冷环境可导致中心体温低于28摄氏度的严重意外低温，并可因自发性或诱发性心室颤动而导致致命后果。
病例报告
三名患者因中心体温低于24摄氏度前来就诊。入院时，患者出现严重的心室节律紊乱（两名处于循环骤停状态，第三名患有心房颤动和循环衰竭）。急救措施包括通过股-股途径使用离心泵进行体外循环并发出内部警报。2例患者预后良好。
讨论
发生严重意外低温（<28摄氏度）并伴有循环衰竭的患者预后很差。死亡通常由严重的节律紊乱导致。使用体外循环辅助进行最佳的紧急复温和氧合可能会成功。
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