Empty ventricle / vena cava syndrome

[Martin Pham Dinh]

Apres discussion avec une collègue sur un cas d'anaphylaxie avec hypotension profonde, je partage avec vous cette référence qui explique pourquoi on devrait généralement traiter les réaction anaphylactique en position couchée, surtout les patients tachycardes ou hypotendus. 

Le "empty vena cava ventricle syndrome" serait une cause non négligeable de décès relativement facile à prévenir. 

What is the empty ventricle syndrome?

• Patients with anaphylaxis should not suddenly sit, stand, or be placed in the upright position.
• Instead, they should be placed on the back with their lower extremities elevated or, if they are experiencing respiratory distress or vomiting, they should be placed in a position of comfort with their lower extremities elevated.
• This accomplishes 2 therapeutic goals: 1) preservation of fluid in the circulation (the central vascular compartment), an important step in managing distributive shock; and 2) prevention of the empty vena cava/empty ventricle syndrome, which can occur within seconds when patients with anaphylaxis suddenly assume or are placed in an upright position.
• Patients with this syndrome are at high risk for sudden death. They are unlikely to respond to epinephrine regardless of route of administration, because it does not reach the heart and therefore cannot be circulated throughout the body

http://resus.me/two-new-anaphylaxis-guidelines/

--

Martin Pham Dinh
martinp...@gmail.com