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Case Reports
. 2021 Apr 16;100(15):e25519.
doi: 10.1097/MD.0000000000025519.

Successful treatment of cardiac arrest following hysteroscopic surgery using extracorporeal membrane oxygenation: A case report

Ting Chen  1 , Li Yao  1 , Fei Tong  2 , Chunyan Zhu  2
Affiliations
Case Reports

Successful treatment of cardiac arrest following hysteroscopic surgery using extracorporeal membrane oxygenation: A case report

Ting Chen et al. Medicine (Baltimore). .

Abstract

Rationale: Cardiac arrest caused by water intoxication syndrome following hysteroscopic surgery is a rare but life-threatening occurrence. Extracorporeal membrane oxygenation (ECMO) is rarely used to treat water intoxication syndrome in hysteroscopic surgery. Here, we successfully treated a patient with water intoxication syndrome following hysteroscopic surgery with ECMO.

Patient concerns: We report a rare case of cardiac arrest during hysteroscopic surgery treated with veno-venous (VV) ECMO.

Diagnosis: Water poisoning syndrome was diagnosed by electrolyte examination, the lowest value of serum sodium was 110.7 mmol/L.

Interventions: VV-ECMO was prescribed as a measure after traditional cardiopulmonary resuscitation.

Results: ECMO was successfully evacuated on day 5 and the patient was discharged on day 45.

Conclusion: Mastering the hysteroscopic operative techniques and using a bipolar hysteroscopic generator, isotonic fluid, perfusion pressures less than 100 mm Hg, and local anesthesia may reduce the risk of hysteroscopic water intoxication syndrome. During hysteroscopic surgery, patients may experience cardiac arrest and fatal water intoxication syndrome. Even when traditional cardiopulmonary resuscitation is successful, VV ECMO may contribute to the recovery of brain function if oxygenation is not maintained.

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Conflict of interest statement

The authors have no funding and conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Echocardiography showing a left ventricular ejection fraction (LVEF) of 62.62%.
Figure 2
Figure 2
Lung ultrasonography showing a large number of B lines.
Figure 3
Figure 3
Computed tomography showing subarachnoid hemorrhage and right renal capsule hematoma.
See this image and copyright information in PMC

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