Stollery Children's Hospital, University of Alberta, Edmonton, AB, Canada.
Pediatr Crit Care Med. 2013 Jun;14(5 Suppl 1):S7-12. doi: 10.1097/PCC.0b013e318292dd10.
The extracorporeal membrane oxygenation circuit is made of a number of components that have been customized to provide adequate tissue oxygen delivery in patients with severe cardiac and/or respiratory failure for a prolonged period of time (days to weeks). A standard extracorporeal membrane oxygenation circuit consists of a mechanical blood pump, gas-exchange device, and a heat exchanger all connected together with circuit tubing. Extracorporeal membrane oxygenation circuits can vary from simple to complex and may include a variety of blood flow and pressure monitors, continuous oxyhemoglobin saturation monitors, circuit access sites, and a bridge connecting the venous access and arterial infusion limbs of the circuit. Significant technical advancements have been made in the equipment available for short- and long-term extracorporeal membrane oxygenation applications. Contemporary extracorporeal membrane oxygenation circuits have greater biocompatibility and allow for more prolonged cardiopulmonary support time while minimizing the procedure-related complications of bleeding, thrombosis, and other physiologic derangements, which were so common with the early application of extracorporeal membrane oxygenation. Modern era extracorporeal membrane oxygenation circuitry and components are simpler, safer, more compact, and can be used across a wide variety of patient sizes from neonates to adults.
体外膜肺氧合回路由许多组件组成,这些组件经过定制,可在长时间(数天至数周)内为严重心脏和/或呼吸衰竭的患者提供足够的组织氧输送。标准的体外膜肺氧合回路由机械血泵、气体交换装置和热交换器组成,通过回路管连接在一起。体外膜肺氧合回路可以从简单到复杂,可能包括各种血流和压力监测器、连续氧合血红蛋白饱和度监测器、回路接入部位以及连接回路静脉接入和动脉输注肢体的桥接。在用于短期和长期体外膜肺氧合应用的设备方面取得了重大技术进步。当代体外膜肺氧合回路具有更好的生物相容性,可以更长时间地支持心肺功能,同时最大限度地减少与早期体外膜肺氧合应用相关的出血、血栓形成和其他生理紊乱等与程序相关的并发症。现代体外膜肺氧合电路和组件更简单、更安全、更紧凑,可用于从新生儿到成人的各种不同体型的患者。