Zusammenfassung
Wir berichten über die kontinuierliche Überwachung der zerebralen Sauerstoffsättigung bei einem 18 Monate alten Mädchens nach Beinahe-Ertrinken und akuter respiratorischer Insuffizienz. Die Messungen, die mit Hilfe eines retrograden fiberoptischen Jugulariskatheter durchgeführt wurden, zeigten im Gegensatz zu den zentral-venösen und arteriellen Werten eine akut bedrohliche zerebrale Sauerstoffuntersättigung an. Nachdem konventionelle Therapiemaßnahmen zur Verbesserung der zerebralen Sauerstoffsättigung fehlschlugen konnte diese erst durch den Einsatz der extrakorporalen veno-venösen Membranoxygenierung (vv ECMO) erreicht werden. Das Mädchen wurde nach 7 Tagen extubiert und ohne neurologische Defekte nach 25 Tagen nach Hause entlassen. In Fällen von Beinahe-Ertrinken ist die kontinuierliche Messung der zerebralen Sauerstoffsättigung mittels eines retrograden fiberoptischen Jugulariskatheters ein wichtiges diagnostisches Instrument, um eine kritische Sauerstoffversorgung des Gehirns frühzeitig zu erfassen.
Summary
We report on monitoring oxygen saturation with a jugular bulb fiber-optical catheter in an 18-month-old girl after fresh water near-drowning followed by acute respiratory failure. The first measured cerebral oxygen saturation was 22% despite normal values for arterial and central venous oxygen saturation. After conventional therapy had failed to improve cerebral oxygen saturation, we started veno-venous extracorporeal membrane oxygenation. Normal levels of cerebral oxygen saturation were achieved after six hours. The girl was extubated after seven days and discharged after twenty-five days in good general condition and without obvious evidence of neurological damage. We believe that in this case of near-drowning, monitoring cerebral oxygen saturation with a jugular bulb catheter was important for surveillance of cerebral hypoxia.
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Hermon, M.M., Golej, J., Burda, G. et al. Monitoring of cerebral oxygen saturation with a jugular bulb catheter after near-drowning and respiratory failure. Wien Klin Wochenschr 115, 128–131 (2003). https://doi.org/10.1007/BF03040293
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DOI: https://doi.org/10.1007/BF03040293
Schlüsselwörter
- Zerebrale Sauerstoffsättigung
- Jugulariskatheter
- Beinahe-Ertrinken
- akute respiratorische Insuffizienz
- zerebrale Sauerstoffuntersättigung
- extrakorporale veno-venöse Membranoxygenierung