腰椎手术中静脉空气栓塞导致心脏骤停，需要俯卧胸外心脏按压：病例报告。

Q4 Medicine

JBJS case connector Pub Date : 2024-12-12 eCollection Date: 2024-10-01 DOI:10.2106/JBJS.CC.24.00431

Joseph E Nassar, Mohammad Daher, Manjot Singh, Ashley Knebel, Sarah L Criddle, Bassel G Diebo, Alan H Daniels

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引用次数: 0

摘要

病例报告：一名76岁女性患者行T12-L4减压融合翻修手术。在手术过程中，发生了大的硬脑膜缺损，伴有潮末CO2突然下降、严重低血压、心动过缓和心脏骤停。开始俯卧胸外按压，患者存活，无术后并发症。突然的血流动力学不稳定归因于静脉空气栓塞（VAE），经术中造影证实。结论：腰椎手术中处理VAE引起的心脏骤停具有挑战性。本病例显示俯卧位胸外按压比等待开始仰卧位胸外按压有更好的生存机会。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Venous Air Embolism During Lumbar Spine Surgery Leading to Cardiac Arrest Requiring Prone Chest Compressions: A Case Report.

Case report: A 76-year-old female patient underwent revision T12-L4 decompression and fusion surgery. During the procedure, a large dural defect occurred associated with an abrupt drop in end-tidal CO2, severe hypotension, bradycardia, and cardiac arrest. Prone chest compressions were initiated, and the patient survived without postoperative comorbidities. The sudden hemodynamic instability was attributed to a venous air embolism (VAE) confirmed by findings on intraoperative capnography.

Conclusion: Managing cardiac arrest caused by VAE in lumbar spine surgery is challenging. This case showcases that prone chest compressions may lead to better survival chances compared with waiting to initiate supine chest compressions.

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来源期刊

JBJS case connector Medicine-Medicine (all)

CiteScore

0.60

自引率

0.00%

发文量

319

期刊介绍： JBJS Case Connector helps improve patient care by providing the medical community with a journal that harnesses technology to provide information tools for discovery and reporting of unusual musculoskeletal problems, findings, treatment, and outcomes. Co-edited by Thomas W. Bauer, MD, PhD, and Ronald W. Lindsey, MD, JBJS Case Connector assists orthopaedic surgeons in the search for precedents, connections, and trends in their efforts to improve patient care. Using this unique journal, surgeons can find the commonalities between cases, benefit from the experience of their peers, and filter case information by many important variables in order to provide the best possible care for orthopaedic patients. This cross-referenced online journal includes thousands of orthopaedic case reports. It compiles symptoms, conditions, and demographic details to empower surgeons to find cases similar to theirs. Surgeons can mine the database to reveal emerging trends and identify patterns, distinguishing between truly rare cases and repeated, related single instances of a larger problem. The JBJS Case Connector Image Quiz feature provides interactive quizzes based on images from content published by JBJS and includes a discussion area for further exploration of ideas and concepts. The JBJS Image Quiz app for iPad and iPhone is available in the App Store. Contributions to JBJS Case Connector are welcomed from anywhere in the world and are considered on their merits. Articles must be written in English and should be submitted as outlined in the Instructions to Authors. All authors must abide by the JBJS ethics policies and all submissions to JBJS Case Connector are covered by the JBJS embargo policy.