- 期刊
Persistent Systemic Air Embolism and Delayed Pulmonary Hemorrhage after Weaning from Cardiopulmonary Bypass-A Case Report
脫離體外心肺循環後發生持續性全身性氣體栓塞及肺出血之病例報告
摘要
手術過程當中發生全身性的氣體栓塞通常伴隨高死亡率與併發症，尤其是發生於心臟手術，或是當病患已經脫離了體外心肺循環之後。少量的氣體栓塞，即可能進入心血管或腦血管而導致器官的嚴重傷害。我們報告的病例是一接受主動脈瓣膜置換手術病患，在順利脫離了體外心肺循環器後，從經食道超音波發現持續出現的氣泡由左右側肺靜脈湧入左心房。起初在診斷氣泡的來源時面臨相當的困惑，並造成處理上的猶豫，最後導致病患的死亡。我們彙整了國內外過去相關的病例報告，並探討可行的診斷與治療。
並列摘要
Systemic air embolism (SAE) occurring during cardiac surgery is usually associated with high morbidity and mortality. We present a fatal case of persistent SAE identified by transesophageal echocardiography (TEE) after weaning from cardiopulmonary bypass (CPB). Perplexities in identification of a bronchovascular fistula and hesitation in aggressive management to arrest the resultant continuous air entry into systemic circulation caused death as an aftermath. Related instances in literature have been reviewed and appropriate managements are herein discussed.
延伸閱讀
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