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本文报告一例在游泳池淹溺约5分钟并有轻度脑外伤的2岁半溺死男孩。在现场和运送途中行基本 CPR,约20分钟后送入医院心肺复苏成功。获救后2(1/2)小时转入 Toronto 儿童医院的 ICU 时,发现 EEG 示平波,神经系统检查提示有急性脑疝伴脑死亡。即使这样,仍坚持“HYPER”治疗方案(按:包括针对水过多、过度通气、体温升高、过度激动、肌肉僵硬五方面的治疗措施)争取脑复苏:①输液量限制在正常的30%,CVP 维持在3～8托,尿量0.5～0.75m1/kg/hr。②控制过度通气,使 PaCO_2维持在30±3托水平;并用高浓度氧及 PEEP10CmH_2O,使 PaO_2150±20托。③低温30
This article reports a 2-and-a-half-year-old boy who drowned in a swimming pool for about 5 minutes with mild brain trauma. In the field and transit basic CPR, about 20 minutes into the hospital after successful CPR. Transferred to the ICU of Toronto Children’s Hospital 2 (1/2) hours after rescuing, EEG was found to show a flat wave and neurological examination revealed acute herniation with brain death. Even so, the “HYPER” treatment plan (including: for over-exaggeration, hyperalgesia, hyperthermia, over-agitation, muscle stiffness and five aspects of treatment measures) to fight for brain recovery: ① infusion limit in the normal 30% , CVP maintained at 3 ~ 8 torr, urine output 0.5 ~ 0.75m1 / kg / hr. ② control hyperventilation, so PaCO_2 maintained at 30 ± 3 Torr level; and with high concentrations of oxygen and PEEP10CmH_2O, PaO_2150 ± 20 torr. ③ low temperature 30