Bệnh nhân Covid-19 ngừng tuần hoàn được điều trị thành công tại bệnh viện đa khoa Sa Đéc: Nhân một trường hợp và nhìn lại Y văn

Abstract

Background: In-hospital cardiac arrest occurs frequently during the COVID-19 pandemic, accounting for 14% of hospitalized patients, which can lead to myocardial dysfunction and death [1]. Only 12% of patients underwent cardio- pulmonary resuscitation survived and were discharged, with 7% had no or mild neurological impairment.[1][1]

Methods: A retrospective description of a COVID19 patient who suffered cardiac arrest. Clinical features, laboratory findings, management, results and brief review of the literature were discussed in depth.

Case presentation: We present a 62-year-old female patient with critical COVID-19. The patient had failed on high-flow nasal ventilation (HFNC) on 9th day of admission, then she was rapidly intubated with no complication, but a cardiac arrest developped 45 minutes after intubation. The patient was rescued by the emergency respond team after 5 minutes of CPR. The cause of cardiac arrest could be attributed to acute respiratory acidosis, acute myocardial injury (myocardial infarction or acute myocarditis) and the consequences of a cytokine storm. Her condition improved under sedation and invasive mecanical ventilation, and she was extubated 6 days after intubation. She was later supported with HFNC following by the oxygen mask, and nasal cannula, respectively. The patient was discharged on 35th day after admission without any neurological impairment.

Conclusion: Delayed intubation in patients who were intolerant with HFNC can lead to poor outcomes. When cardiac arrest occurs, proper emergency respond by experienced doctors can help to increase the likelihood of successful resuscitation and to reduce the risk of neurological complications.