The nursing experience of a patient with low cardiac output syndrome after heart valve replacement and treated by extracorporeal membrane oxygenation combined with cardiopulmonary bypass was reported. In view of the patient's critical and complex condition and rapid progression,a series of measures were taken,including bedside thoracotomy for hemostasis under cardiopulmonary bypass by multidisciplinary collaboration,actively correcting reversible factors leading to low cardiac output,bedside seamless management of cardiopulmonary bypass and extra corporeal membrane oxygenation(ECMO),the precision management of ECMO anticoagulation after cardiopulmonary bypass,monitoring and management of brain function,capacity and distal limb ischemia during the running of venous-arterial ECMO to ensure sufficient blood and oxygen supply of heart,lung,brain and other important organs and no fatal complications,make patients go through pump failure. After 6 days of careful treatment and nursing,the cardiac function of the patient recovered to the expected goal,and the ECMO was successfully evacuated.
ZHOU Sha
,
ZENG Fei
,
MAO Qinna
,
SHOU Feiping
,
HUANG Guifei
. Nursing care of a patient with low cardiac output syndrome treated by bedside extracorporeal membrane oxygenation combined with cardiopulmonary bypass[J]. Chinese Journal of Emergency and Critical Care Nursing, 2023
, 4(1)
: 36
-39
.
DOI: 10.3761/j.issn.2096-7446.2023.01.006
[1] 张海涛,杜雨,曹芳芳,等. 低心排血量综合征中国专家共识[J]. 解放军医学杂志,2017,42(11):933-944.
Zhang HT,Du Y,Cao FF,et al.National consensus on low cardiac output syndrome in China[J]. Med J Chin LPA,2017,42(11):933-944.
[2] 俞晓立,张冬成,林清文,等. 重症瓣膜病的外科治疗[J]. 中外医学研究,2013,11(19):18-19,20.
Yu XL,Zhang DC,Lin QW,et al.Surgical treatment of severe valvular heart disease[J]. Chin Foreign Med Res,2013,11(19):18-19,20.
[3] 贾明,王红,周晔,等. 体外膜肺氧合在心脏手术后心肺复苏困难患者的应用[J]. 中国体外循环杂志,2014,12(2):73-76.
Jia M,Wang H,Zhou Y,et al.Application of extracorporeal membrane oxygenation for prolonged cardiopulmonary resuscitation patients after cardiac surgery[J]. Chin J Extracorpor Circ,2014,12(2):73-76.
[4] 王红,杨峰,贾明,等. 成人体外循环脱机困难的体外膜式人工肺氧合治疗单中心早期临床结果[J]. 心肺血管病杂志,2014,33(6):844-848.
Wang H,Yang F,Jia M,et al.Analysis of the early outcomes for patients with failure to wean from cardiopulmonary bypass necessitating extracorporeal membrane oxygenation support:from a single center[J]. J Cardiovasc Pulm Dis,2014,33(6):844-848.
[5] Li CL,Wang H,Jia M,et al.The early dynamic behavior of lactate is linked to mortality in postcardiotomy patients with extracorporeal membrane oxygenation support:a retrospective observational study[J]. J Thorac Cardiovasc Surg,2015,149(5):1445-1450.
[6] 王玉金. 标准化护理在低心排综合征ECMO治疗中的应用[J]. 中国卫生标准管理,2021,12(18):150-152.
Wang YJ.Application of standardized nursing in ECMO treatment of low cardiac output syndrome[J]. China Heal Stand Manag,2021,12(18):150-152.
[7] 薛婷,邱小松,李丽,等. 无肝素V-V ECMO在创伤性ARDS患者中的应用[J]. 中华急诊医学杂志,2020,29(2):234-236.
Xue T,Qiu XS,Li L,et al.Application of heparin-free V-V ECMO in patients with traumatic ARDS[J]. Chin J Emerg Med,2020,29(2):234-236.
[8] Alexander GR.A retrospective review comparing the treatment outcomes of emergency lung resection for massive haemoptysis with and without preoperative bronchial artery embolization[J]. Eur J Cardiothorac Surg,2014,45(2):251-255.
[9] 蒋国平,徐永山. 体外膜肺氧合并发症的防治研究进展[J]. 浙江医学,2022,44(9):901-907.
Jiang GP,Xu YS.Extracorporeal membrane oxygenation the research progress of prevention and cure of complications[J]. Zhejiang Med J,2022,44(9):901-907.
[10] 杜雨,张海涛. 低心排血量综合征中国专家共识解读[J]. 中国循环杂志,2018,33(S2):84-88.
Du Y,Zhang HT.Chinese expert consensus on low cardiac output syndrome[J]. Chin Circ J,2018,33(S2):84-88.