PDF(Pubmed)
Abstract：
BACKGROUND: Clinical attempts of extracorporeal cardiopulmonary resuscitation (ECPR) in patients with out-of-hospital cardiac arrest (OHCA) have increased in recent years; however, it also has life-threatening complications. Massive fluid and transfusion resuscitation, shock status, or low cardiac output status during ECPR may lead to ascites and interstitial edema, resulting in secondary abdominal compartment syndrome (ACS).
METHODS: A 43-year-old male patient was admitted to the emergency department due to cardiac arrest. Due to refractory ventricular fibrillation, ECPR was initiated. Approximately, 3 h after extracorporeal membrane oxygenation support, abdominal distension and rigidity developed. Therefore, ACS was suspected. Decompression laparotomy was required to relieve elevated intra-abdominal pressure.
CONCLUSIONS: We report a case of a patient with OHCA who developed lethal ACS after ECPR. Despite this, the patient was able to recover from several major crises. Regardless of how lethal the patient is, if compartment syndrome develops in any part of the body, we should aggressively consider surgical decompression.
METHODS: A 43-year-old male patient was admitted to the emergency department due to cardiac arrest. Due to refractory ventricular fibrillation, ECPR was initiated. Approximately, 3 h after extracorporeal membrane oxygenation support, abdominal distension and rigidity developed. Therefore, ACS was suspected. Decompression laparotomy was required to relieve elevated intra-abdominal pressure.
CONCLUSIONS: We report a case of a patient with OHCA who developed lethal ACS after ECPR. Despite this, the patient was able to recover from several major crises. Regardless of how lethal the patient is, if compartment syndrome develops in any part of the body, we should aggressively consider surgical decompression.
摘要：
背景：院外心脏骤停（OHCA）患者体外心肺复苏（ECPR）的临床尝试近年来有所增加；然而，它也有危及生命的并发症。大量液体和输血复苏，休克状态,或ECPR期间的低心输出量状态可能导致腹水和间质水肿，导致继发性腹腔室综合征（ACS）。
方法：一名43岁的男性患者因心脏骤停进入急诊科。由于难治性心室纤颤,ECPR已经启动。大约,体外膜氧合支持后3小时，腹胀和强直。因此,ACS被怀疑。需要开腹减压术以减轻腹内压升高。
结论：我们报告一例OHCA患者在ECPR后发展为致死性ACS。尽管如此,病人从几次重大危机中恢复过来。不管病人有多致命，如果筋膜室综合征在身体的任何部位发展，我们应该积极考虑手术减压。
方法：一名43岁的男性患者因心脏骤停进入急诊科。由于难治性心室纤颤,ECPR已经启动。大约,体外膜氧合支持后3小时，腹胀和强直。因此,ACS被怀疑。需要开腹减压术以减轻腹内压升高。
结论：我们报告一例OHCA患者在ECPR后发展为致死性ACS。尽管如此,病人从几次重大危机中恢复过来。不管病人有多致命，如果筋膜室综合征在身体的任何部位发展，我们应该积极考虑手术减压。
