ABSTRACT
Resumen La ablación con catéter de taquicardia ventricular ha demostrado mejorar la supervivencia y algunas veces es el único tratamiento efectivo, sobre todo en tormenta arrítmica; sin embargo la presencia de inestabilidad hemodinámica dificulta el procedimiento. El soporte con oxigenación por membrana extracorpórea (ECMO) es una alternativa para lograr el mapeo y ablación de taquicardia ventricular durante largos periodos de tiempo. Se presenta el caso de un paciente con cardiopatía isquémica y taquicardia ventricular con inestabilidad hemodinámica, en quien se realiza la ablación exitosa del sustrato mediante soporte con ECMO veno-arterial, sin episodios de taquicardia ventricular durante dos años de seguimiento.
Abstract Catheter ablation is useful for reducing drug refractory ventricular tachycardia (VT) episodes and can be life-saving when VT is incessant or arrhythmic storm. Left ventricular hemodynamic support may be required in patients with VT and hemodynamic instability. Extracorporeal membrane oxygenation (ECMO) support is an alternative to achieve ventricular tachycardia mapping and ablation over long periods of time. We present a case of successful catheter ablation of substrate in a patient with ischemic heart disease and ventricular tachycardia with hemodynamic instability performed using venous- arterial ECMO support. There were not episodes of ventricular tachycardia after 2 years of follow-up.
ABSTRACT
Objective To explore the nursing experience of the safe intra-hospital transport of patients with the severe aspiration of the inhalation injury. Method The nursing measures for the intra-hospital transport of 2 cases of smoke pot inhalation injury caused by extracorporeal membrane oxygenation treatment were taken, including disease risk assessment, preparation for transport, organization of a transport team, effective vital signs monitoring during transport, extracorporeal membrane oxygenation (ECMO) pipeline monitoring and nursing and observation and nursing of complications. Result No emergency was found during the transport of patients and both of them were safely transported. Conclusion Such nursing measures as pre-transport assessment and preparation and bettering predictive nursing for the patients with severe inhalation pulmonary injury treated with extracorporeal membrane oxygenation are key to the safety during intra-hospital transport.
ABSTRACT
Fatal anaphylactic reactions to protamine sulfate during cardiac surgery are very rare. We report a case of catastrophic bronchial spasm due to an anaphylactic reaction to protamine. The patient was managed successfully using a bronchodilator, steroid treatment, and extracorporeal membrane oxygenation.