Lindstrom Steven J, Pellegrino Vincent A, Butt W Warwick
Alfred Hospital, and Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia.
Med J Aust. 2009 Aug 3;191(3):178-82. doi: 10.5694/j.1326-5377.2009.tb02735.x.
Extracorporeal membrane oxygenation (ECMO) is a technique that involves oxygenation of blood outside the body, and provides support to selected patients with severe respiratory or cardiac failure. The two major ECMO modalities are venoarterial and venovenous. Data from several randomised trials support the use of ECMO in neonatal respiratory failure, and a recent randomised controlled trial of ECMO in adults has produced encouraging results. The evidence base for ECMO use in cardiac disease is developing, but progress has been slowed by considerations of clinical equipoise and evolving indications for ECMO. Advancing ECMO technology and increasing experience with ECMO techniques have improved patient outcomes, reduced complications and expanded the potential applications of ECMO. Awareness of the indications and implications of ECMO among doctors managing patients with severe but potentially reversible respiratory or cardiac failure may help facilitate better communication between health care teams and improve patient recovery.
体外膜肺氧合（ECMO）是一种在体外对血液进行氧合的技术，为选定的严重呼吸或心力衰竭患者提供支持。ECMO的两种主要模式是静脉-动脉模式和静脉-静脉模式。多项随机试验的数据支持ECMO用于新生儿呼吸衰竭，最近一项针对成人的ECMO随机对照试验也取得了令人鼓舞的结果。ECMO在心脏病治疗中的循证基础正在发展，但由于临床 equipoise 的考量和ECMO适应证的不断演变，进展有所放缓。ECMO技术的进步以及对ECMO技术经验的增加改善了患者预后，减少了并发症，并扩大了ECMO的潜在应用范围。在管理严重但可能可逆的呼吸或心力衰竭患者的医生中提高对ECMO适应证和影响的认识，可能有助于促进医疗团队之间更好的沟通，并改善患者康复情况。
