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Cardiogenic Shock and Lung Injury as a Complication of Defibrillation

Cocuk Acil ve Yogun Bakım, 2017-12, Vol.4 (3), p.130-134 [Peer Reviewed Journal]

2017. This work is published under https://creativecommons.org/licenses/by-nc/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. ;ISSN: 2146-2399 ;EISSN: 2717-9206 ;EISSN: 2148-7332 ;DOI: 10.4274/cayd.98680

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  • Title:
    Cardiogenic Shock and Lung Injury as a Complication of Defibrillation
  • Author: Kıhtır, Hasan Serdar ; Osman Yeşilbaş ; Şevketoğlu, Esra ; Mey, Talip Petmezci ; Balkaya, Seda ; Mehmet Bedir Akyol ; Kıhtır, Zeynep
  • Subjects: defibrillator ; Defibrillators ; Edema ; Heart failure ; lung injury ; Pulmonary edema ; thermodilution
  • Is Part Of: Cocuk Acil ve Yogun Bakım, 2017-12, Vol.4 (3), p.130-134
  • Description: Local burns, embolism, and arrhythmia are the most common side effects observed after electrical shock treatments. However, systolic function may be rarely affected and pulmonary edema may develop. The cases of pulmonary edema after electrical shock treatments have been reported since 1960s and the proposed mechanism is the inadequacy of the left atrium cuff and ventricle. It was learned that a 7-year-old-girl without any known disease except vesicoureteral reflux had a ventricular fibrillation during general anesthesia induction and defibrillation at 2 joule/kg was attempted. It was also learned that the procedure was delayed and the patient was diagnosed with a long QT (QTc: 0.47 ms) and had respiratory distress and circulatory disturbances after four hours. Pulmonary edema and heart failure was determined, and due to hipoxemia (SpO2 <88%) not getting any better with non-invasive ventilation, the patient was intubated and followed with mechanical ventilation. A thermodilution catheter was inserted into the femoral artery and a low cardiac index (CI): 1.58 L/min/m2, elevated extravascular lung water index (EVLWI): 18 mL/kg and high pulmonary vascular permeability index (PVPI): 7.6 were determined. The patient was treated by mechanical ventilation and vasoactive/inotropic management and discharged at the fifth day of hospitalization without any sequela. Having high EVLWI with high PVPI suggest that the pulmonary edema mechanism may also be caused by alveolocapillary membrane damage, which is not accompanied by heart failure alone. This case is presented to show that it is the first child in the literature and that the results of transpulmonary thermodilution can also give information about lung function as well as cardiac function.
  • Publisher: Istanbul: Galenos Publishing House
  • Language: English;Turkish
  • Identifier: ISSN: 2146-2399
    EISSN: 2717-9206
    EISSN: 2148-7332
    DOI: 10.4274/cayd.98680
  • Source: ProQuest Central
    DOAJ Directory of Open Access Journals
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