Division of Pulmonary, Allergy and Critical Care, Columbia University College of Physicians and Surgeons, PH 8E, Room 101, New York, NY 10032, USA.
Division of Pulmonary, Allergy and Critical Care, Columbia University College of Physicians and Surgeons, PH 14E, Room 104, New York, NY 10032, USA.
Clin Chest Med. 2017 Dec;38(4):655-666. doi: 10.1016/j.ccm.2017.07.006. Epub 2017 Sep 19.
Extracorporeal life support in lung transplantation has been associated with poor posttransplant outcomes. However, recent advances have resulted in more favorable posttransplant outcomes. The increased use of this technology must be weighed against the risks inherent in its use, especially when complications arising in extracorporeal membrane oxygenation (ECMO)-dependent patients result in loss of transplant candidacy, leaving them with no viable alternative for long-term support. Existing and emerging data support the judicious use of this technology in carefully selected patients at high-volume transplant and ECMO centers that prioritize minimization of sedation, avoidance of endotracheal intubation, and early mobilization.
体外生命支持在肺移植中与较差的移植后结果相关。然而，最近的进展导致了更有利的移植后结果。必须权衡这种技术的使用风险，特别是当体外膜氧合（ECMO）依赖患者的并发症导致丧失移植资格时，因为他们没有可行的长期支持替代方案。现有的和新兴的数据支持在高容量移植和 ECMO 中心，在仔细选择的患者中谨慎使用这种技术，这些中心优先考虑最小化镇静、避免气管插管和早期活动。
