Endovascular Cooling Catheter-Related Thrombosis After Targeted Temperature Management for Out-of-Hospital Cardiac Arrest: A Case Report.
Endovascular Cooling Catheter-Related Thrombosis After Targeted Temperature Management for Out-of-Hospital Cardiac Arrest: A Case Report.
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院外心脏骤停目标温度管理后血管内冷却导管相关血栓形成：病例报告。
DOI：
10.1089/ther.2019.0044
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发表时间：
2020
影响因子：
1.2
通讯作者：
Imai Hiroshi
中科院分区：
文献类型：
--
作者：
Ikejiri Kaoru;Suzuki Kei;Ishikura Ken;Imai Hiroshi
血管内冷却导管相关血栓形成是靶向温度管理（TTM）的一种未被充分认识的临床并发症，TTM广泛用于治疗昏迷的院外心脏骤停幸存者。一名16岁的男孩，在院外心脏骤停中幸存下来，使用血管内冷却系统接受了TTM。将34°C的目标温度保持24小时，然后以0.5°C/12小时的速率复温。第5天，在取出血管内冷却导管后，他的体温急剧上升。他被诊断为肺炎和耐甲氧西林金黄色葡萄球菌菌血症。断层扫描检查也显示肝功能明显异常。第7天，检测到一个大血栓延伸通过右髂静脉并进入下腔静脉（IVC）。由于菌血症，不需要放置IVC滤器，静脉注射肝素和抗凝血酶后血栓消失。除了心搏骤停状态下导管相关血栓形成和高凝状态的潜在风险外，急性肝损伤和感染状态也可能导致血栓形成。
Endovascular cooling catheter-related thrombosis is an under-recognized clinical complication of targeted temperature management (TTM), which is widely used in the treatment of comatose out-of-hospital cardiac arrest survivors. A 16-year-old boy, who survived an out-of-hospital cardiac arrest, underwent TTM with an endovascular cooling system. A target temperature of 34°C was maintained for 24 hours, followed by rewarming at a rate of 0.5°C/12 hours. On day 5, his body temperature rose sharply after the removal of the endovascular cooling catheter. He was diagnosed with pneumonia and methicillin-resistantStaphylococcus aureusbacteremia. Tomography investigations also revealed a marked abnormality in the liver function. On day 7, a large thrombus extending through the right iliac vein and into the inferior vena cava (IVC) was detected. Owing to bacteremia, the IVC filter placement was not indicated, and the thrombus disappeared after intravenous administration of heparin and antithrombin. In addition to the potential risk of catheter-related thrombosis and hypercoagulability in the postcardiac arrest state, acute liver injury and an infective state may contribute to thrombosis.
影响因子：
6.5
作者：
Gillies, Michael A.;Pratt, Rosalie;Tibby, Shane M.
通讯作者：
Tibby, Shane M.
影响因子：
6.5
作者：
Andremont, Olivier;du Cheyron, Damien;Sauneuf, Bertrand
通讯作者：
Sauneuf, Bertrand