Sarver Heart Center, University of Arizona, Tucson (P.R.).
Division of Cardiothoracic Surgery, Department of Surgery, University of Arizona, Tucson (Z.K.).
Circ Heart Fail. 2018 Sep;11(9):e004905. doi: 10.1161/CIRCHEARTFAILURE.118.004905.
Venoarterial extracorporeal membrane oxygenation (VA-ECMO)-also referred to as extracorporeal life support-is a form of temporary mechanical circulatory support and simultaneous extracorporeal gas exchange. The initiation of VA-ECMO has emerged as a salvage intervention in patients with cardiogenic shock, even cardiac arrest refractory to standard therapies. Analogous to veno-venous ECMO for acute respiratory failure, VA-ECMO provides circulatory support and allows time for other treatments to promote recovery or may be a bridge to a more durable mechanical solution in the setting of acute or acute on chronic cardiopulmonary failure. In this review, we provide a brief overview of VA-ECMO, the attendant physiological considerations of peripheral VA-ECMO, and its complications, namely that of left ventricular distention, bleeding, heightened systemic inflammatory response syndrome, thrombosis and thromboembolism, and extremity ischemia or necrosis.
静脉-动脉体外膜肺氧合（VA-ECMO）——也称为体外生命支持——是一种临时机械循环支持和同时进行体外气体交换的形式。VA-ECMO 的启动已成为心源性休克患者的抢救干预措施，即使对标准治疗无效的心脏骤停患者也是如此。类似于急性呼吸衰竭的静脉-静脉 ECMO，VA-ECMO 提供循环支持，并为其他治疗提供时间以促进恢复，或者在急性或慢性心肺衰竭的情况下可能成为更持久的机械解决方案的桥梁。在这篇综述中，我们简要概述了 VA-ECMO、外周 VA-ECMO 的相关生理注意事项及其并发症，即左心室扩张、出血、全身炎症反应综合征加剧、血栓形成和血栓栓塞以及肢体缺血或坏死。
