Leligdowicz Aleksandra, Fan Eddy
aInterdepartmental Division of Critical Care Medicine, University of Toronto bThe University Health Network, Toronto, Ontario, Canada.
Curr Opin Crit Care. 2015 Feb;21(1):13-9. doi: 10.1097/MCC.0000000000000170.
To provide a summary of the recent literature on extracorporeal membrane oxygenation (ECMO) in adults with severe acute respiratory distress syndrome (ARDS), focusing on advances in equipment, current conventional and unconventional indications, complications, and future applications.
ECMO use has increased during the past 5 years. Advances in cannulation, circuit design, and patient selection have made it a safer therapeutic option in severe ARDS, and its use has become more widespread for nonconventional indications.
High-quality evidence for the routine use of ECMO for management of adult patients with severe ARDS is still lacking. An ongoing randomized controlled trial (ECMO to rescue lung injury in severe ARDS) will contribute valuable data to guide clinical decisions to opt for this supportive therapy.
总结近期关于成人重症急性呼吸窘迫综合征（ARDS）体外膜肺氧合（ECMO）的文献，重点关注设备进展、当前常规及非常规适应证、并发症和未来应用。
在过去5年中，ECMO的使用有所增加。插管、回路设计和患者选择方面的进展使其在重症ARDS中成为更安全的治疗选择，并且其在非常规适应证中的应用也更为广泛。
对于常规使用ECMO治疗成人重症ARDS，目前仍缺乏高质量证据。一项正在进行的随机对照试验（ECMO挽救重症ARDS肺损伤）将提供有价值的数据，以指导临床决定是否选择这种支持性治疗。
