tailieunhanh - Báo cáo y học: "Abdominal only CPR during cardiac arrest for a patient with an LVAD during resternotomy: A case report"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Wertheim cung cấp cho các bạn kiến thức về ngành y đề tài: Abdominal only CPR during cardiac arrest for a patient with an LVAD during resternotomy: A case report. | Rottenberg et al. Journal of Cardiothoracic Surgery 2011 6 91 http content 6 1 91 JCTS JOURNAL OF CARDIOTHORACIC SURGERY CASE REPORT Open Access Abdominal only CPR during cardiac arrest for a patient with an LVAD during resternotomy A case report Eric M Rottenberg1 Jarrett Heard2 Robert Hamlin3 Benjamin C Sun4 and Hamdy Awad5 Abstract We present a case in which a patient with a previous sternotomy and left ventricular assist device LVAD implantation developed cardiac arrest during resternotomy for LVAD exchange. The surgeon refused chest compressions for fear of potential damage to the inflow cannula directly beneath the sternum. The perioperative team had no alternatives to external cardiac massage other than rapid deployment of extra-corporeal membrane oxygenation for mechanical support so the anesthesiologist advised the nursing personnel to perform abdominal only cardiopulmonary resuscitation while the surgeon performed a femoral bypass to cannulate the groin for extracorporeal membrane oxygenation support. Background Cardiac arrest during cardiac surgery is a unique situation. In 2009 the European Society of Cardiothoracic Surgery published a separate guideline that addressed these particular situations including the timing of emergency resternotomy the number of attempts at defibrillation before reopening the administration of epinephrine and emergency resternotomy sets 1 . However this guideline did not address the treatment of patients with a mechanical assist device in cardiac arrest situations since their treatment is highly complicated. Cardiac arrest may be due to mechanical failure and external cardiac massage ECM is not appropriate as stated by the European Society of Cardiothoracic Surgery 1 . We present a case in which the patient with a previous sternotomy and LVAD HeartMate II Thoratec Corporation implantation developed cardiac arrest during resternotomy for LVAD exchange due to hemolysis. The surgeon denied chest .