Küstermann Julian, Brederlau Jörg, Kranke Peter, Roewer Norbert, Muellenbach Ralf Michael
Klinik und Poliklinik für Anästhesiologieder Universität Würzburg.
Anasthesiol Intensivmed Notfallmed Schmerzther. 2012 Oct;47(10):646-54. doi: 10.1055/s-0032-1329402. Epub 2012 Oct 24.
In patients with the most severe forms of acute respiratory distress syndrome (ARDS) refractory to conventional mechanical ventilation and adjunctive or rescue therapies like kinetic therapy, inhaled vasodilators or extracorporeal CO2-elimination (extracorporeal lung assist), the use of the extracorporeal membrane oxygenation (ECMO) can secure gas exchange. Due to technical improvements and miniaturization, the new ECMO system is safer and simpler. Nowadays the ECMO-systems are heparin-coated, so that there is no need of therapeutic systemic anticoagulation, and thus bleeding complications are less frequent. Recent data suggests, that outcome of patients with severe ARDS treated with ECMO may improve. This review describes the function and the management of ECMO-therapy in ARDS-patients.
对于患有最严重形式的急性呼吸窘迫综合征（ARDS）且对传统机械通气以及诸如动态治疗、吸入血管扩张剂或体外二氧化碳清除（体外肺辅助）等辅助或挽救疗法无效的患者，使用体外膜肺氧合（ECMO）可确保气体交换。由于技术改进和小型化，新型ECMO系统更安全、更简便。如今的ECMO系统采用肝素涂层，因此无需进行全身性治疗抗凝，从而出血并发症的发生率较低。近期数据表明，接受ECMO治疗的重症ARDS患者的预后可能会改善。本综述描述了ARDS患者ECMO治疗的功能及管理。
