肺移植期间体外膜肺氧合与体外循环的比较：一项荟萃分析。
Extracorporeal membrane oxygenation versus cardiopulmonary bypass during lung transplantation: a meta-analysis.
作者信息
Magouliotis Dimitrios E, Tasiopoulou Vasiliki S, Svokos Alexis A, Svokos Konstantina A, Zacharoulis Dimitris
机构信息
Department of Surgery, University Hospital of Larissa, Larissa, Greece.
Department of Surgery, Faculty of Medicine, University of Thessaly, Viopolis, Larissa, Greece.
出版信息
Gen Thorac Cardiovasc Surg. 2018 Jan;66(1):38-47. doi: 10.1007/s11748-017-0836-3. Epub 2017 Sep 16.
BACKGROUND
We reviewed the available literature on patients undergoing lung transplantation supported by cardiopulmonary bypass (CPB) or extracorporeal membrane oxygenation (ECMO).
METHODS
A systematic literature search was performed in three databases, in accordance with the PRISMA guidelines. Meta-analyses were used to compare the outcomes of ECMO and CPB procedures.
RESULTS
Seven observational studies met the inclusion criteria incorporating 785 patients. ECMO support showed lower rate of primary graft dysfunction, bleeding, renal failure requiring dialysis, tracheostomy, intraoperative transfusions, intubation time, and hospital stay. Total support time was greater for the ECMO-supported group. No difference was reported between operative and ischemic time.
CONCLUSIONS
The present study indicates that the intraoperative use of ECMO is associated with increased efficacy and safety, regarding short-term outcomes, compared to CPB. Well-designed, randomized studies, comparing ECMO to CPB, are necessary to assess their clinical outcomes further.
背景
我们回顾了有关接受体外循环（CPB）或体外膜肺氧合（ECMO）支持的肺移植患者的现有文献。
方法
根据PRISMA指南，在三个数据库中进行了系统的文献检索。采用荟萃分析比较ECMO和CPB手术的结果。
结果
七项观察性研究符合纳入标准，共纳入785例患者。ECMO支持显示原发性移植物功能障碍、出血、需要透析的肾衰竭、气管切开术、术中输血、插管时间和住院时间的发生率较低。ECMO支持组的总支持时间更长。手术时间和缺血时间之间未报告差异。
结论
本研究表明，与CPB相比，术中使用ECMO在短期结果方面具有更高的疗效和安全性。有必要进行精心设计的、比较ECMO和CPB的随机研究，以进一步评估它们的临床结果。
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