| Japanese |
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| Title | 長時間の心肺蘇生により完全社会復帰できた一症例 |
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| Subtitle | 症例 |
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| Authors | 矢田浩*, 森本裕二*, 劔物修*, 加藤紘之**, 田辺達三**, 安田慶秀*** |
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| Authors(kana) | |
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| Organization | *北海道大学医学部麻酔学教室, **北海道大学医学部第2外科学講座, ***北海道大学医学部付属病院循環器外科 |
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| Journal | 循環制御 |
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| Volume | 13 |
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| Number | 1 |
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| Page | 161-165 |
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| Year/Month | 1992/ |
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| Article | 報告 |
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| Publisher | 日本循環制御医学会 |
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| Abstract | 「要旨」40分以上心肺蘇生に時間を要しながらも, 後遺症を残さず社会復帰しえた症例を経験した. 患者は70才男性, 膵頭十二指腸切除が予定された. 麻酔はエンフルレンと硬膜外麻酔で維持した. 手術開始の90分後, 突然心室細動を認め, 直ちに, 心肺蘇生を開始したが, 心拍再開まで40分以上要した. 心拍再開後も低心拍出量状態が持続したため, 大動脈内バルーンポンプ(IABP)を挿入した. その後著明な改善を認め, 一ヵ月後には後遺症を全く残さず社会復帰が可能となった. その要因として, (1)心肺蘇生に速やかに着手した. (2)開胸式心マッサージを有効に行えた. (3)自己心拍再開後IABPを使用し循環動態を安定させることができた. ことが考えられた. 「はじめに」昨今, 心肺脳蘇生法に対する新しい試みがさまざまな角度からなされている1)2). しかしながら, 一般的には心肺停止後, 神経学的に後遺症を残さず回復が期待できる許容時間は, 低体温などの特殊な場合を除き依然として短時間に限られている. Abramsonらは262人の心肺蘇生患者の心停止時間と予後との関係を検討し, たとえ心停止から心肺蘇生着手までの時間が6分以内でも蘇生に要した時間が30分を超えると予後が明らかに不良となることを報告している3). |
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| Practice | 基礎医学・関連科学 |
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| Keywords | cardiopulmonary resuscitation, cardiac massage, intraaortic balloon pump |
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| English |
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| Title | Successful resuscitation without any sequelae following long term of cardiopulmonary resuscitation -A Case report- |
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| Subtitle | |
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| Authors | Hiroshi Yada*, Yuji Morimoto*, Osamu Kemmotsu*, Hiroymki Katoh**, Tatsuzoh Tanabe**, Keishyu Yasuda*** |
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| Organization | *Department of Anesthesiology Hokkaido University School of Medicine, **Second Department of Surgery Hokkaido University School of Medicine, ***Department of Cardiovascular Sugery Hokkaido University School of Medicine |
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| Journal | Circulation Control |
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| Volume | 13 |
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| Number | 1 |
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| Page | 161-165 |
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| Year/Month | 1992/ |
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| Article | Report |
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| Publisher | Japan Society of Circulation Control |
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| Abstract | A 70year old male was scheduled to undergo pancreatoduodenectomy. He had mild liver disfunction and diabetes mellitus, which was treated by 50 units of insulin per day. General, anesthesia was maintained by enflurane and N2O combined with epidural anesthesia. After 90 min of operation, blood pressure decreased and QRS waves became widened in ECG, and then ventricular fibrillation suddenly occurred. Although CPR was immediately initiated, it took more than 40 min to regain his spontaneous heart beat. Low cardiac output state still continued, in spite of high doses of catecholamine. Intraaortic balloon pump was induced and thereafter circulatory conditions were normalized. He was treated in the intensive care unit, and he showed marked improvement including return of consciousness. One month later he was discharged without any sequelae. The following three major factors may contribute to this successful resuscitation ; immediate initiation of CPR, open chest cardiac massage dufing CPR, immediate stabilization of circulatory conditions by intraaortic balloon pump after regain of spontaneous heartbeats. |
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| Practice | Basic medicine |
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| Keywords | cardiopulmonary resuscitation, cardiac massage, intraaortic balloon pump |
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