体外循环常规肝素逆转期间蛋白蛋白相关的非心源性肺水肿

Medical Reports Pub Date : 2025-04-25 DOI:10.1016/j.hmedic.2025.100205

Leslie Kim, Hai-Yen Nguyen, Taegen Senawong, Claudia Wei

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引用次数: 0

摘要

一位62岁男性因冠状动脉旁路移植术（CABG）和主动脉瓣置换术（AVR）而就诊。在开始静脉（IV）鱼精蛋白治疗肝素逆转后，患者出现急性肺水肿，其特征是氧饱和度降低和气道压力增加，需要静脉动脉体外膜氧合（VA-ECMO）进行肺恢复。本病例报告讨论了与鱼精蛋白相关的非心源性肺水肿（NCPE）的病理生理，并与典型的鱼精蛋白反应进行了比较。在鱼精蛋白通常用于逆转肝素抗凝作用的手术过程中，麻醉师必须意识到这种潜在的危及生命的并发症。麻醉学，心脏/胸外科/血管外科

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Protamine-related non-cardiogenic pulmonary edema during routine heparin reversal for cardiopulmonary bypass

A 62-year-old male presented for coronary artery bypass graft (CABG) and aortic valve replacement (AVR). Following initiation of intravenous (IV) protamine for heparin reversal, the patient developed acute pulmonary edema characterized by reduced oxygen saturations and increasing airway pressures necessitating venoarterial extracorporeal membrane oxygenation (VA-ECMO) for lung recovery. This case report discusses the pathophysiology of protamine-related non-cardiogenic pulmonary edema (NCPE) and its comparison to typical protamine reactions. Anesthesiologists must be aware of this potentially life-threatening complication during procedures where protamine is commonly used to reverse the effects of heparin anticoagulation.