Le Guen M, Parquin F
Service anesthésie, département d'anesthésie-réanimation, hôpital Foch, université de Versailles Saint-Quentin-en-Yvelines, 40, rue Worth, 92151 Suresnes, France.
Unité de soins intensifs respiratoires, hôpital Foch, université de Versailles Saint-Quentin-en-Yvelines, Suresnes, France.
Rev Mal Respir. 2015 Apr;32(4):358-69. doi: 10.1016/j.rmr.2014.09.006. Epub 2014 Oct 30.
Extra-corporeal membrane oxygenation (ECMO) effectively replaces the lung in providing oxygenation and carbon dioxide (CO2) removal. For some years, and in parallel to the H1N1 influenza pandemic, this technique has gained interest in relation to significant technological improvements, leading to new concepts of "awake and mobile ECMO" or rehabilitation with ECMO. Finally, the publication of randomized controlled trials giving encouraging results in the adult respiratory distress syndrome (ARDS) has helped to validate this technique and further studies are warranted. This general review aims to outline the definition, classification and principles of ECMO and to give some current information about the indications and possibilities of the technique to the pulmonologist and intensivist. Further possible uses for this technique include extra-corporeal removal of CO2 during hypercapnic respiratory failure and assistance during lung transplantation from the preoperative to the early postoperative period.
体外膜肺氧合（ECMO）在提供氧合和清除二氧化碳（CO2）方面能有效替代肺功能。数年来，在甲型H1N1流感大流行期间，这项技术因显著的技术改进而受到关注，催生了“清醒和可移动ECMO”或ECMO康复等新概念。最后，关于成人呼吸窘迫综合征（ARDS）的随机对照试验结果令人鼓舞，这有助于验证该技术，有必要开展进一步研究。本综述旨在概述ECMO的定义、分类和原理，并向肺科医生和重症监护医生提供有关该技术适应症和可能性的一些当前信息。该技术的其他可能用途包括在高碳酸血症呼吸衰竭期间体外清除CO2以及在肺移植术前至术后早期提供辅助。
