妊娠期心脏骤停:潮末CO2监测可指导院前处理

S. Einvik, T. Lafrenz, Stein-Vegar Johansen, I. M. Ringen, P. Bredmose
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引用次数: 0

摘要

本病例报告描述了一名27岁孕妇,胎龄26周零3天,在家中发生心脏骤停。急救立即开始,并在抵达医院后继续进行。妊娠期间心脏骤停在医院复苏的指导方针包括,如果在4分钟内没有恢复自发循环,应进行剖宫产术。这种情况下院前治疗的指导方针更具争议性。现场分诊是基于潮汐末二氧化碳(ETCO2)监测,显示正在进行的复苏质量是熟练的,在现场很短的时间后,患者被送到急诊室进行PMCS。母亲的复苏没有成功,但在分娩前28分钟的总骤停时间后,婴儿存活了下来,没有任何后遗症。监测妊娠期心脏骤停复苏时的ETCO2可能有助于决定是否在现场或在医院更合适的位置进行PMCS。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Cardiac Arrest in Pregnancy: End-Tidal CO2 Monitoring Could Guide Management in the Prehospital Setting
This case report describes a 27-year-old pregnant woman with a gestational age of 26 weeks and 3 days who developed cardiac arrest in her home. Resuscitation was started immediately and continued on arrival at the hospital. Guidelines for resuscitation of cardiac arrest during pregnancy in-hospital include that a perimortem caesarean section (PMCS) should be performed if there is no return of spontaneous circulation within 4 minutes. The guidelines for prehospital treatment in such circumstances are more controversial. The triage on-site was based on the end-tidal carbon dioxide (ETCO2) monitoring showing that the quality of resuscitation being done was proficient and after a short on-scene time the patient was transported to the emergency department for PMCS on arrival. The resuscitation of the mother was not successful but the baby survived with no known sequelae after a total arrest time of 28 minutes before delivery. Monitoring of ETCO2 in resuscitation of cardiac arrest in pregnancy might be helpful in making the decision on whether to perform PMCS on-site or at a somewhat more appropriate location in the hospital.
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