Küstermann J, Gehrmann A, Kredel M, Wurmb T, Roewer N, Muellenbach R M
Klinik und Poliklinik für Anästhesiologie, ARDS/ECMO-Zentrum, Universität Würzburg, Oberdürrbacherstr. 6, 97080, Würzburg, Deutschland.
Anaesthesist. 2013 Aug;62(8):639-43. doi: 10.1007/s00101-013-2213-7. Epub 2013 Aug 7.
A 30-year-old patient was admitted to hospital with fever and respiratory insufficiency due to community acquired pneumonia. Within a few days the patient developed septic cardiomyopathy and severe acute respiratory distress syndrome (ARDS) which deteriorated under conventional mechanical ventilation. Peripheral venoarterial extracorporeal membrane oxygenation (va-ECMO) was initiated by the retrieval team of an ARDS/ECMO centre at a paO2/FIO2 ratio of 73 mmHg and a left ventricular ejection fraction (EF) of 10 %. After 12 h va-ECMO was converted to veno-venoarterial ECMO (vva-ECMO) for improvement of pulmonary and systemic oxygenation. Left ventricular function improved (EF 45 %) 36 h after starting ECMO and the patient was weaned from vva-ECMO and converted to vv-ECMO. The patient was weaned successfully from vv-ECMO after 5 additional days and transferred back to the referring hospital for weaning from the ventilator.
一名30岁患者因社区获得性肺炎伴发热和呼吸功能不全入院。数天内，患者发展为感染性心肌病和严重急性呼吸窘迫综合征（ARDS），在传统机械通气下病情恶化。一个ARDS/ECMO中心的抢救团队在患者氧分压/吸入氧分数值（PaO2/FIO2）为73 mmHg且左心室射血分数（EF）为10%时启动了外周静脉-动脉体外膜肺氧合（va-ECMO）。12小时后，va-ECMO转换为静脉-静脉-动脉体外膜肺氧合（vva-ECMO）以改善肺和全身氧合。启动ECMO 36小时后左心室功能改善（EF为45%），患者撤离vva-ECMO并转换为vv-ECMO。5天后患者成功撤离vv-ECMO，并转回转诊医院以撤离呼吸机。
