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来自首都医科医院的王志坚医师分享了一例心跳骤停伴心脏泵衰竭病例。患者在转院途中出现心跳骤停40分钟,医师综合应用PIE-2R模式,即有效的循环呼吸支持系统:Pacemaker、IABP、ECMO、Respiratory与Revascularization成功挽救患者生命。以下为来自王志坚医师的病例的诊断资料与手术详细过程展示,以期各位专家学者交流探讨。
Generalinformation(Male,52years)Presentillness:Suddenonsetofretrosternalchestpain.Rushedtotheemergencydepartment,Cardiacarrestfor1.51.5hours(40minutes).MCPR+50minutesofECPR.
Pasthistory:Nonhypertensive,nopriorhistoryofD.O.E.noknownhistoryofDM.
Riskfactor:nosmoking.
UCG:Globalakinetic,EF16%.
EKG:VFib.
electrocardiogram:Continue4hoursofCPR,numerouselectriccardioversion.PersistentVFAnyhopeforthispatient?Giveup?
ECMOwasused4hoursafterCPR:
ECMOassistedPCI(EPCI)Setp1:
Setp2:PEA-PCI.
Discuss:Theculpritvessel(TheECGwasamess):RCA?LAD?Strategy:Completerevascularization?Onlyculpritvessel?
Setp3:GivingHopetotheHopeless.
Setp4:TheBeaconofHope.
Setp5:TriedtoopentheLADbutfailed.CTO?
Setp6:Afterrevascularization,thepatientgotheartrhythmafterelectriccardioversionJ.IABPwasinserted.
CasesummaryPIE-2R:ThemodeandfuturedirectionforresuscitationinAMI-CS.
WhatisPIE-2R:PIE-2Ristheapplicationof