Rodríguez GME, Tamayo BY, Picrin DD

Language: Spanish
References: 10
Page: 261-266
PDF size: 39.66 Kb.

ABSTRACT

Introduction: exsanguinating injuries still pose a challenge in terms of time for anesthesiologists and emergency doctors as the neurological recovery is inversely proportional to the ischemia time at brain level.
Objective: to describe the perioperative behavior and evolution of a patient with pulseless electrical activity secondary to exsanguinating complex wound.
Description of the case: a patient treated at the Department of Anesthesiology in "Dr. Agostinho Neto" General Teaching Hospital of Guantanamo province , who showed no response and central pulses (cardiac arrest criteria by current standards) after an exsanguinating injury at the level of the antero-internal area of the right thigh related to the femoral artery and vein. After 54 minute-, resuscitation procedure, stable vital parameters were achieved, which allowed the admission of the patient to the operating room, the repair of injuries with perioperative intensive treatment and finally favorable evolution until discharge. Details of the preoperative resuscitation and the applied anesthetic follow-up were provided as well as the present considerations in literature in respect to the anesthetic behavior to be followed in these patients.
Conclusion: the treatment of these cases is singular because these are patients with poor prognosis and low survival, all of which can be effectively reversed with the assistance staff being more aware of the rescue of these victims and with the team work with high professionalism.

REFERENCES

1. Guyton RA: The Myocardium: Physiology and Protection During Cardiac Surgery and Cardiopulmonary Bypass. Baltimore. Ed. Williams and Wilkins. 2005. pp. 21-35.

2. Johansen JV: Myocardial Protection during Cardiac Surgery. Cardiopulmonary Bypass. Baltimore. Ed. Williams and Wilkins. 2006. pp. 155-195.

3. Safar P. Cerebral resuscitation after cardiac arrest: research initiatives and future directions. Ann Emerg Med 1993; 22: 324-349

4. Forcadas M: Protección Miocárdica. Re Española de Perfusión 2009; 2: 5-21.

5. Luna OP. Anestesia Cardiovascular. México. Ed. McGraw-Interamericana. 2007. pp. 416-430.

6. Mora TC: Cardiopulmonary Bypass. New York. Ed. Springer-Verlag. 2010. pp. 21-35.

7. Eigh IG. Myocardial Protection. J Cardiac Surgery. 1984; 87: 509-516.

8. Miller JD. Assessing patients with head injury. Br J Surg 2006; 77:241-242.

9. García RC. Farmacología anestésica en unidades de reanimación. Rev Esp Anestesiol Reanim 2009; 42: 3.

10. Christopher M: Blood Quadriplegic. Perfusion 2007; 6: 245-252.