- 期刊
Successful Hyperbaric Oxygen Therapy for a Cardiac Arrest Child with Drowning: A Case Report and Literature Review
小兒溺水致心肺停止使用高壓氧成功治療病例報告曁文獻回顧
摘要
在2000年代普遍公認高壓氧對缺氧性腦病變具有一定的療效，其可能的機轉被認為藉由微細循環改善腦部代謝，進而改善腦部缺氧狀況，藉由腦部血管收縮效應以降低顱內水種現象，藉由改善血腦屏障，增進腦部血流通透性以保全腦部部分受損細胞，並避免更多腦細胞缺血壞死。在台灣鄉村急診室常有因溺水導致心肺停止的個案，但經由心肺復甦術及高壓氧治療而能悻存的案例卻少之又少。經由這位具有高死亡率的溺水案例，我們學習到藉由高壓氧的治療應可活化腦部沉睡瀕死之神經細胞，因此我們建議對於溺水導致缺氧性腦病變，並經由心肺復甦術倖存下來的案例，值得儘速給於高壓氧執行心肺腦復甦，以避免因缺氧性腦病變致植物人之缺憾。
並列摘要
By 2000, the consensus was that hyperbaric oxygen therapy (HBO) was effective in hypoxic encephalopathy patients. The possible mechanism of HBO in neurological disorders is relief of hypoxia, improvement of microcirculation and cerebral metabolism, reduced cerebral edema by vasoconstrictive effect, increases the permeability of the blood-brain barrier and preservation of partially damaged tissue and prevention of further progression of secondary effects of cerebral lesions. In cardiac arrest following submersion accidents is one of the common presentation in most rural emergency departments at Taiwan. But cardiac arrest with performed CPR subsequently the HBO therapy leading to full recovery is rarely seen. Such a case potentially has a high rate of mortality. From this case as know the direct effect of hyperbaric oxygenation therapy on sleeping neural cells. Submersion should be considered in HBO therapy may be one of the key point to benefit the patient. Hence we present here a successful experience in the management of submersion to put emphasis on cardiopulmonary-cerebral resuscitation (CPCR) use to completely resuscitate patients who receive CPR to minimize their tragic progression to a vegetative state.