Emergency department initiation of percutaneous cardiopulmonary support for traumatic cardiac tamponade with coagulated pericardial effusion

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• 作者：Hideyuki Nakano^a ; ^{hyrn1070@hosp.niigata.niigata.jp" class="auth_mail} ; ^{hyrn1070@gmail.com" class="auth_mail} ; Yasuo Hirose^a ; Takehito Mishima^b ; Satoshi Nakazawa^b ; Yuki Sato^a ; Kazuki Kobayashi^a
• 关键词：Blunt traumatic cardiac rupture ; Cardiac tamponade ; PCPS ; Percutaneous cardiopulmonary support ; Extracorporeal membrane oxygenation ; FAST ; Emergent median sternotomy
• 刊名：Injury Extra
• 出版年：April, 2014
• 年：2014
• 卷：45
• 期：4
• 页码：29-31
• 全文大小：573 K

文摘

Cardiac rupture following blunt trauma is associated with a high mortality rate. We present a rescued case of blunt traumatic cardiac tamponade successfully initiated with percutaneous cardiopulmonary support (PCPS) at the emergency department (ED) without pericardiocentesis.

A 27-year-old woman was transferred to our hospital after a motor vehicle accident. She presented with profound shock, and the cardiac portion of the focussed assessment of sonography for trauma (FAST) showed almost coagulated pericardial effusion. We considered that the haemodynamic collapse was caused by cardiac tamponade, and we initiated PCPS in the ED. Subsequently, her systemic perfusion was preserved by PCPS, and she was transferred to the operating room safely. A laceration of the right atrium was successfully repaired. In cardiac tamponade, blood accumulation in the pericardium may be localised and the formation of blood clots may cause difficulty with aspiration. The initiation of PCPS afforded time to surgeons prior to definitive surgical repair and enabled the patient's transfer to the operating room securely.

This report demonstrated the case of a rare, but successful outcome of resuscitation of a patient with blunt traumatic cardiac rupture with cardiac tamponade. PCPS is considered as an important treatment option in ED for traumatic cardiac tamponade, particularly if the effusion has clotted.