Department of Anesthesiology and Intensive Care Medicine, University Hospital, Georg-August University of Göttingen, Robert Koch Straße 40, Göttingen 37075, Germany.
Department of Medicine (DMED), Anesthesia and Intensive Care Unit, Padua University Hospital, Via C.Battisti, 267, Padua 35128, Italy.
Crit Care Clin. 2018 Jul;34(3):413-422. doi: 10.1016/j.ccc.2018.03.011.
Extracorporeal gas exchange is increasingly used for various indications. Among these are refractory acute respiratory failure, including the acute respiratory distress syndrome (ARDS), and the avoidance of ventilator-induced lung injury (VILI) by enabling lung-protective ventilation. Additionally, extracorporeal gas exchange allows the treatment of hypercapnic respiratory failure while helping to unload the respiratory muscles and avoid intubation and invasive ventilation, as well as facilitating weaning from the ventilator. These indications are based on a reasonable physiologic rationale but must be weighed against the costs and complications associated with the technique. This article summarizes current evidence and indications for extracorporeal gas exchange.
体外气体交换越来越多地用于各种适应症。其中包括难治性急性呼吸衰竭，包括急性呼吸窘迫综合征（ARDS），以及通过实现肺保护性通气来避免呼吸机引起的肺损伤（VILI）。此外，体外气体交换还可以治疗高碳酸血症性呼吸衰竭，同时有助于减轻呼吸肌负担，避免插管和有创通气，并有助于从呼吸机上脱机。这些适应症基于合理的生理原理，但必须权衡与该技术相关的成本和并发症。本文总结了体外气体交换的当前证据和适应症。
