Donker Dirk W, Brodie Daniel, Henriques José P S, Broomé Michael
1 Department of Intensive Care Medicine, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
2 Division of Pulmonary, Allergy and Critical Care Medicine, Columbia University College of Physicians and Surgeons/New York-Presbyterian Hospital, New York, NY, USA.
Perfusion. 2019 Mar;34(2):98-105. doi: 10.1177/0267659118794112. Epub 2018 Aug 16.
Short-term mechanical support by veno-arterial extracorporeal membrane oxygenation (VA ECMO) is more and more applied in patients with severe cardiogenic shock. A major shortcoming of VA ECMO is its variable, but inherent increase of left ventricular (LV) mechanical load, which may aggravate pulmonary edema and hamper cardiac recovery. In order to mitigate these negative sequelae of VA ECMO, different adjunct LV unloading interventions have gained a broad interest in recent years. Here, we review the whole spectrum of percutaneous and surgical techniques combined with VA ECMO reported to date.
静脉-动脉体外膜肺氧合（VA ECMO）的短期机械支持在重度心源性休克患者中应用越来越广泛。VA ECMO的一个主要缺点是其会使左心室（LV）机械负荷出现变化但必然增加，这可能会加重肺水肿并阻碍心脏恢复。为了减轻VA ECMO的这些不良后果，近年来不同的辅助左心室卸载干预措施引起了广泛关注。在此，我们综述了迄今为止报道的与VA ECMO相结合的经皮和外科技术的全貌。
