Japanese
Title術中心停止に対しPCPSを使用した1症例
Subtitle症例
Authors山野上敬夫*, 吉田研一*, 和泉博通*, 大澤恭浩*, 世良昭彦*, 硲光司*, 渡橋和政**, 末田泰二郎**, 弓削孟文*
Authors(kana)
Organization*広島大学医学部麻酔・蘇生学教室, **広島大学医学部第1外科学教室
Journal循環制御
Volume16
Number4
Page574-577
Year/Month1995/
Article報告
Publisher日本循環制御医学会
Abstract心停止は麻酔管理中に生じうる最も重大な合併症であり, 特に予定手術の場合は, いかに病態が重篤で蘇生困難であっても最大限の努力が払われる必要がある. 今回は手術終了直後の予期せぬ心停止に対する心肺蘇生に際して, 経皮的心肺補助装置(PCPS)を使用した. 「症例」症例は64歳男性で, 身長165cm, 体重72kgであった. 1994年初め頃より排尿困難があり, 同年10月5日当院泌尿器科を受診し, 精査の結果, 多発性膀胱腫瘍と診断された. 既往歴として特発性血小板減少性紫斑病があった. 1993年8月に当院内科にて診断され, プレドニゾロン5mg/日投与により血小板数7〜11万/mm3にコントロールされていた. 1日40〜50本, 30年間の喫煙歴があったが, 高血圧や狭心症の既往はなかった. 家族歴に特記すべきことはなく, 突然死した血縁者もいなかった. 理学的に異常所見はなく, 心音は正常で心雑音も認めなかった. 血液検査では, 白血球数が12,000/mm3と増多, 血小板数は11.0×104/mm3と減少していた.
Practice基礎医学・関連科学
KeywordsPercutaneous cardiopulmonary support, Cardiac arrest, Postoperative
English
TitlePercutaneous Cardiopulmonary Support Resuscitating Unexpected Cardiac Arrest Immediately after Surgery
Subtitle
AuthorsTakao Yamanoue*, Kenichi Yoshida*, Yasuhiro Ohsawa*, Hiromichi Izumi*, Akihiko Sera*, Kouji Hazama*, Kazumasa Orihashi**, Taijiro Sueda**, Osafumi Yuge*
Authors(kana)
Organization*Department of Anesthesiology and Critical Care Medicine, Hiroshima University School of Medicine, **First Department of Surgery, Hiroshima University School of Medicine
JournalCirculation Control
Volume16
Number4
Page574-577
Year/Month1995/
ArticleReport
PublisherJapan Society of Circulation Control
AbstractPercutaneous cardiopulmonary support (PCPS) was used for resuscitating unexpected cardiac arrest immediately after surgery. The patient was a 64 year-old male, and total cystectomy with illial conduit was finished. Just after the extubation of the endotracheal tube, he was suffered from unexpected ventricular fibrillatjon. Conventional cardiopulmonary resuscitation brought only elecromechanical dissociation. Accordingly, PCPS was started 42 minutes after the cardiac arrest. Heart beat was recovered and blood pressure was maintained soon after the initiation of PCPS. The patient became conscious in the first postoperative day (1POD). Unfortunately, because of a decrease of blood platelet count and a progression of hemolysis we could not continue PCPS in 5POD, and we lost him in 6POD. Although the life was not saved, PCPS for the unexpected intraoperative cardiac arrest was useful in avoiding could-be table death. It also possessed an important aspect in that the cerebral blood flow was maintained and the patient became conscious. (Circ Cont 16：574〜577, 1995)
PracticeBasic medicine
KeywordsPercutaneous cardiopulmonary support, Cardiac arrest, Postoperative

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