TY - A2的铃木Manzo盟——Sugiyama雪盟——Aiba Kazuma盟,Arai Nariaki AU -伊藤,非盟- Urasawa圆子Chie盟,村上Masatoshi AU - Hirose郁子盟,田中Ryusuke盟,山田Tomokatsu盟——Iida圭佑盟,中村Hiroyuki AU -川俣町,Mikito PY - 2021 DA - 2021/04/15 TI -成功的管理一个患者术中出血超过80000毫升和有用性监测钙对高职院校学前教育专业修正SP - 6635696六世- 2021 AB -术中大量出血与高死亡率和麻醉管理大量出血是具有挑战性的因为在大量输血时，必须同时实现容量复苏和电解质校正。我们报告一例在肝移植过程中出现超过80000毫升的危及生命的出血，在这种情况下，实时QTc监测对于治疗低钙血症的大量钙给药非常有用。一名47岁女性，因多囊性肝病肝脏巨大，计划接受肝移植。手术中发生了危及生命的大出血。最大失血量约为15,000毫升/小时，估计总失血量为81,600毫升。维持血压极其困难，由于低血压，心脏骤停的风险持续存在。此外，即使给予胰岛素和钙，高钾血症和低钙血症的电解质紊乱与QTc间隔时间延长。当时，我们直观地注意到QT间期因大量钙给药而缩短，我们使用实时QTc间期的变化作为钙校正的支持指标。 This monitoring allowed for us to administer calcium at an unusually high rate, by which progression of hypocalcemia was prevented. Levels of hemoglobin and coagulation factors were preserved both by restriction of crystalloid infusion and by a massive transfusion protocol. The patient was extubated without pulmonary edema or cardiac overload and was finally discharged without any sequelae. Intensive and cooperative management for massive transfusion and electrolyte correction using QTc monitoring was considered to be a key for successful management. SN - 2090-6382 UR - https://doi.org/10.1155/2021/6635696 DO - 10.1155/2021/6635696 JF - Case Reports in Anesthesiology PB - Hindawi KW - ER -