Zhang X, Sun B, Pac-Soo C, Ma D, Wang L. A case report: A patient rescued by VA-ECMO after cardiac arrest triggered by trigeminocardiac reflex after nasal surgery.
Medicine (Baltimore) 2023;
102:e35226. [PMID:
37773828 PMCID:
PMC10545381 DOI:
10.1097/md.0000000000035226]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 08/24/2023] [Indexed: 10/01/2023] Open
Abstract
RATIONALE
Cardiac arrest (CA) caused by trigeminocardiac reflex (TCR) after endoscopic nasal surgery is rare. Hence, when a patient suffers from TCR induced CA in the recovery room, most doctors may not be able to find the cause in a short time, and standard cardiopulmonary resuscitation and resuscitation measures may not be effective. Providing circulatory assistance through venous-arterial extracorporeal membrane oxygenation (VA-ECMO) can help healthcare providers gain time to identify the etiology and initiate symptom-specific treatment.
PATIENT CONCERNS
We report a rare case of CA after endoscopic nasal surgery treated with VA-ECMO.
DIAGNOSES
We excluded myocardial infarction, pulmonary embolism, allergies, hypoxia, and electrolyte abnormalities based on the relevant examination results. Following a multidisciplinary consultation, clinical manifestation and a review of previous literature, we reasoned that the CA was due to TCR.
INTERVENTIONS
VA-ECMO was established to resuscitate the patient successfully during effective cardiopulmonary resuscitation.
OUTCOMES
ECMO was successfully evacuated a period of 190 minutes of therapy. The patient was discharged home on day 8.
LESSONS
TCR is notable during endoscopic nasal surgery. Our case indicates that CA in operating room is worth prolonged CCPR. The ideal time for ECPR implementation should not be limited within 20 minutes after CCPR.
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