背景:鼻内镜手术后由三叉神经心脏反射(TCR)引起的心脏骤停(CA)很少见。因此,当患者在康复室遭受TCR诱导的CA时,大多数医生可能无法在短时间内找到原因,标准心肺复苏和复苏措施可能无效。通过静脉-动脉体外膜氧合(VA-ECMO)提供循环辅助可以帮助医疗保健提供者获得时间来确定病因并启动症状特异性治疗。
方法:我们报告了1例罕见的经VA-ECMO鼻内镜手术治疗的CA病例。
方法:我们排除了心肌梗死,肺栓塞,过敏,缺氧,根据相关检查结果,电解质异常。经过多学科协商,临床表现和以前的文献回顾,我们推断CA是由于TCR。
方法:建立了VA-ECMO,以在有效的心肺复苏过程中成功复苏患者。
结果:ECMO在190分钟的治疗时间内成功撤离。患者在第8天出院回家。
结论:TCR在鼻内镜手术中是显著的。我们的案例表明,手术室中的CA值得延长CCPR。实施ECPR的理想时间不应限制在CCPR后20分钟内。
BACKGROUND: Cardiac arrest (CA) caused by trigeminocardiac reflex (TCR) after endoscopic nasal surgery is rare. Hence, when a patient suffers from TCR induced CA in the recovery room, most doctors may not be able to find the cause in a short time, and standard cardiopulmonary resuscitation and resuscitation measures may not be effective. Providing circulatory assistance through venous-arterial extracorporeal membrane oxygenation (VA-ECMO) can help healthcare providers gain time to identify the etiology and initiate symptom-specific treatment.
METHODS: We report a rare
case of CA after endoscopic nasal surgery treated with VA-ECMO.
METHODS: We excluded myocardial infarction, pulmonary embolism, allergies, hypoxia, and electrolyte abnormalities based on the relevant examination results. Following a multidisciplinary consultation, clinical manifestation and a review of previous literature, we reasoned that the CA was due to TCR.
METHODS: VA-ECMO was established to resuscitate the patient successfully during effective cardiopulmonary resuscitation.
RESULTS: ECMO was successfully evacuated a period of 190 minutes of therapy. The patient was discharged home on day 8.
CONCLUSIONS: TCR is notable during endoscopic nasal surgery. Our
case indicates that CA in operating room is worth prolonged CCPR. The ideal time for ECPR implementation should not be limited within 20 minutes after CCPR.