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首页> 外文期刊>Seminars in cardiothoracic and vascular anesthesia >Successful rescue of an adult with refractory anaphylactic shock and abdominal compartment syndrome with venoarterial extracorporeal membrane oxygenation and bedside laparotomy
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Successful rescue of an adult with refractory anaphylactic shock and abdominal compartment syndrome with venoarterial extracorporeal membrane oxygenation and bedside laparotomy

机译：经静脉动脉体外膜氧合和床旁剖腹术成功治愈难治性过敏性休克和腹腔室综合征的成人

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摘要

The incidence of life-threatening anaphylactic reactions related to anesthesia is approximately 1 in 6000 anesthetics administered, and is associated with mortality as high as 5%. In such cases the use of extracorporeal membrane oxygenation (ECMO) in the setting of refractory shock following anaphylaxis may be life saving. Abdominal compartment syndrome (ACS) itself and in this case complicating ECMO support, is a potentially devastating complication of high-volume resuscitation. Decompressive laparotomy is the treatment of choice for ACS. We present a patient treated with venoarterial ECMO for refractory shock following anaphylaxis who developed ACS that was successfully treated with urgent decompressive laparotomy performed in the intensive care unit. This case report highlights the role of abdominal compartment syndrome as a rare but potentially fatal cause of low circuit flow in ECMO-supported patients and proposes a stepwise approach to decision making in this setting. Urgent decompressive laparotomy is potentially lifesaving in this circumstance, and should be urgently considered once other causes of low ECMO flow have been excluded.
机译：与麻醉有关的威胁生命的过敏反应的发生率在6000剂麻醉药中大约1发生，并且与高达5％的死亡率有关。在这种情况下，过敏反应后难治性休克中使用体外膜氧合（ECMO）可能会挽救生命。腹腔室综合征（ACS）本身，在这种情况下使ECMO支持复杂化，是大剂量复苏的潜在破坏性并发症。减压剖腹术是ACS的治疗选择。我们介绍了一名患者，在过敏反应后接受了静脉动脉ECMO治疗，用于难治性休克，该患者发展了ACS，并在重症监护室成功实施了紧急减压剖腹术治疗。该病例报告强调了腹腔室综合征在ECMO支持的患者中作为低回路流量的罕见但潜在致命原因的作用，并提出了在这种情况下进行决策的逐步方法。在这种情况下，紧急减压剖腹手术可能会挽救生命，一旦排除了其他导致ECMO流量低的原因，则应紧急考虑。

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