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静脉-动脉体外膜肺氧合(V-A ECMO)疗法在心源性休克患者短期机械循环支持中的应用。

Application of V-A ECMO therapies for short-term mechanical circulatory support in patients with cardiogenic shock.

作者信息

Musiał Robert, Darocha Tomasz, Kosiński Sylweriusz, Stoliński Jarosław, Sadowski Jerzy, Drwiła Rafał

机构信息

Department of Anaesthesiology and Intensive Care, John Paul II Specialist Hospital in Krakow, Poland.

出版信息

Anaesthesiol Intensive Ther. 2015;47(4):324-7. doi: 10.5603/AIT.2015.0046.

Abstract

BACKGROUND

The aim of the study was to present our experience with short-term mechanical circulatory support by veno-arterial extracorporeal membrane oxygenation (V-A ECMO). A series of cases is described involving patients with symptoms of severe cardiogenic shock successfully treated with V-A ECMO.

CASE REPORTS

Depending on indications, veno-venous (V-V) or veno-arterial (V-A) ECMO can be used. The patients described here presented symptoms of severe cardiogenic shock and the ECMO kit was successfully applied as an element of circulatory support. V-A ECMO was used as a bridge to recovery in a patient after pulmonary artery embolectomy and a bridge to heart transplantation in a patient with giant cell myocarditis; in the third case, ECMO was applied to the treatment of cardiogenic shock in deep hypothermia.

CONCLUSIONS

The number of cases in which ECMO has been successfully applied in patients with cardiogenic shock and in deep hypothermia is increasingly high; therefore, it seems advisable to elaborate ECMO guidelines to be used in such situations. V-A ECMO is an effective and recognized method of treatment of patients in cardiogenic shock and deep hypothermia.

摘要

背景

本研究的目的是介绍我们使用静脉-动脉体外膜肺氧合(V-A ECMO)进行短期机械循环支持的经验。描述了一系列病例,这些患者患有严重心源性休克症状,通过V-A ECMO成功治疗。

病例报告

根据适应症,可使用静脉-静脉(V-V)或静脉-动脉(V-A)ECMO。这里描述的患者表现出严重心源性休克症状,ECMO套件作为循环支持的一个组成部分成功应用。V-A ECMO在一名肺动脉栓子切除术后的患者中用作恢复的桥梁,在一名巨细胞心肌炎患者中用作心脏移植的桥梁;在第三个病例中,ECMO应用于治疗深度低温下心源性休克。

结论

ECMO已成功应用于心源性休克和深度低温患者的病例数量越来越多;因此,制定在这种情况下使用的ECMO指南似乎是可取的。V-A ECMO是治疗心源性休克和深度低温患者的一种有效且公认的方法。

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