心脏术后和非心脏术后休克患者进行静脉-动脉体外膜肺氧合期间的临床并发症：仍然是致命弱点。
Clinical complications during veno-arterial extracorporeal membrane oxigenation in post-cardiotomy and non post-cardiotomy shock: still the achille's heel.
作者信息
Lo Coco Valeria, Lorusso Roberto, Raffa Giuseppe M, Malvindi Pietro Giorgio, Pilato Michele, Martucci Gennaro, Arcadipane Antonio, Zieliński Kamil, Suwalski Piotr, Kowalewski Mariusz
机构信息
Department of Cardio-Thoracic Surgery, Heart and Vascular Centre, Maastricht University Medical Centre, Maastricht, The Netherlands.
Department of the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, IRCCS-ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione), Palermo, Italy.
出版信息
J Thorac Dis. 2018 Dec;10(12):6993-7004. doi: 10.21037/jtd.2018.11.103.
Abstract
Extracorporeal membrane oxygenation (ECMO) is life-saving for potentially reversible heart failure and respiratory injuries not responsive to conventional therapies. Technological innovations have produced over the years significant improvements in ECMO devices (pump, cannula design and oxygenator) and have allowed a better risk/benefit profile. Alongside with recognized advantages in the treatment of very sick patients, ECMO remains an invasive procedure for mechanical circulatory support (MCS) and it is associated with complications that strongly influence the prognosis. Current review was designed to provide a comprehensive outline on ECMO complications, analyzing risk factors and strategies of management, focusing on adult population undergoing veno-arterial ECMO (VA-ECMO) therapy.
摘要
体外膜肺氧合（ECMO）对于潜在可逆的心力衰竭和对传统治疗无反应的呼吸损伤具有挽救生命的作用。多年来，技术创新使ECMO设备（泵、插管设计和氧合器）有了显著改进，并带来了更好的风险/效益比。除了在治疗重症患者方面具有公认的优势外，ECMO仍然是一种用于机械循环支持（MCS）的侵入性操作，并且与严重影响预后的并发症相关。本综述旨在全面概述ECMO并发症，分析危险因素和管理策略，重点关注接受静脉-动脉ECMO（VA-ECMO）治疗的成年人群。
相似文献
1
Clinical complications during veno-arterial extracorporeal membrane oxigenation in post-cardiotomy and non post-cardiotomy shock: still the achille's heel.心脏术后和非心脏术后休克患者进行静脉-动脉体外膜肺氧合期间的临床并发症：仍然是致命弱点。
J Thorac Dis. 2018 Dec;10(12):6993-7004. doi: 10.21037/jtd.2018.11.103.
2
Structured review of post-cardiotomy extracorporeal membrane oxygenation: Part 2-pediatric patients.心脏手术后体外膜肺氧合的系统评价：第 2 部分-儿科患者。
J Heart Lung Transplant. 2019 Nov;38(11):1144-1161. doi: 10.1016/j.healun.2019.07.004. Epub 2019 Jul 17.
3
Hemostatic complications and systemic heparinization in pediatric post-cardiotomy veno-arterial extracorporeal membrane oxygenation failed to wean from cardiopulmonary bypass.小儿心脏术后静脉-动脉体外膜肺氧合脱离体外循环失败时的止血并发症及全身肝素化
Transl Pediatr. 2022 Sep;11(9):1458-1469. doi: 10.21037/tp-22-104.
4
Veno-arterial extracorporeal membrane oxygenation (VA ECMO) in postcardiotomy cardiogenic shock: how much pump flow is enough?心脏术后心源性休克的静脉-动脉体外膜肺氧合（VA ECMO）：多少泵流量才足够？
J Thorac Dis. 2016 Oct;8(10):E1444-E1448. doi: 10.21037/jtd.2016.10.01.
5
Extracorporeal Membrane Oxygenation in Adults - Variants, Complications during Therapy, and the Role of Radiological Imaging.成人体外膜肺氧合——变体、治疗期间的并发症及放射影像学的作用
Rofo. 2017 Feb;189(2):119-127. doi: 10.1055/s-0042-118885. Epub 2016 Dec 29.
6
Analysis of the Food and Drug Administration Manufacturer and User Facility Device Experience Database for Patient- and Circuit-Related Adverse Events Involving Extracorporeal Membrane Oxygenation.对美国食品药品监督管理局制造商及用户设施设备经验数据库中涉及体外膜肺氧合的患者及回路相关不良事件的分析。
Cardiovasc Revasc Med. 2020 Feb;21(2):230-234. doi: 10.1016/j.carrev.2019.11.011. Epub 2019 Nov 20.
7
Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) for emergency cardiac support.静脉-动脉体外膜肺氧合（VA-ECMO）用于紧急心脏支持。
J Crit Care. 2018 Apr;44:31-38. doi: 10.1016/j.jcrc.2017.10.011. Epub 2017 Oct 12.
8
Position of draining venous cannula in extracorporeal membrane oxygenation for respiratory and respiratory/circulatory support in adult patients.体外膜肺氧合中用于成人呼吸和呼吸/循环支持的静脉引流管位置。
Crit Care. 2018 Jun 15;22(1):163. doi: 10.1186/s13054-018-2083-0.
9
Acute coronary syndrome associated cardiogenic shock in the catheterization laboratory: peripheral veno-arterial extracorporeal membrane oxygenator management and recommendations.导管室中急性冠状动脉综合征相关的心源性休克：外周静脉-动脉体外膜肺氧合管理及建议
Front Med (Lausanne). 2023 Nov 7;10:1277504. doi: 10.3389/fmed.2023.1277504. eCollection 2023.
10
Veno-arterial extracorporeal membrane oxygenation: Special reference for use in 'post-cardiotomy cardiogenic shock' - A review with an Indian perspective.静脉-动脉体外膜肺氧合：用于“心脏术后心源性休克”的特别参考——基于印度视角的综述
Indian J Thorac Cardiovasc Surg. 2021 Apr;37(Suppl 2):275-288. doi: 10.1007/s12055-020-01051-7. Epub 2020 Nov 7.
引用本文的文献
1
Survival Predictors and Clinical Outcomes in Patients Undergoing Venoarterial ECMO: A 7-Year Retrospective Study.接受静脉-动脉体外膜肺氧合治疗患者的生存预测因素及临床结局：一项7年回顾性研究
Crit Care Res Pract. 2025 Aug 22;2025:5588093. doi: 10.1155/ccrp/5588093. eCollection 2025.
2
Successful Management of a Posterior Post-Infarction Ventricular Septal Defect and Mitral Regurgitation with Delayed Surgery-A Case Report and Overview of the Literature.延迟手术成功治疗心肌梗死后室间隔缺损合并二尖瓣反流——病例报告及文献综述
Reports (MDPI). 2025 Jun 4;8(2):87. doi: 10.3390/reports8020087.
3
Inhaled nitric oxide therapy is effective in improving right ventricular function in patients receiving ECPELLA support.吸入一氧化氮疗法对接受体外膜肺氧合（ECPELLA）支持的患者改善右心室功能有效。
Gen Thorac Cardiovasc Surg. 2025 Jul 20. doi: 10.1007/s11748-025-02181-8.
4
Different Paths, Same Goals: A Comparative Study on the Safety of Femoral vs. Axillary Arterial Cannulation in VA ECMO.殊途同归：VA-ECMO中股动脉与腋动脉插管安全性的比较研究
J Clin Med. 2025 Jun 29;14(13):4613. doi: 10.3390/jcm14134613.
5
Extracorporeal membrane oxygenation for adults with respiratory failure secondary to cardiorespiratory disease: evolving indications and clinical practice.用于患有心肺疾病继发呼吸衰竭的成人的体外膜肺氧合：不断演变的适应症和临床实践
Breathe (Sheff). 2025 Jan 21;21(1):240119. doi: 10.1183/20734735.0119-2024. eCollection 2025 Jan.
6
Predicting In-Hospital Mortality in Patients with End-Stage Renal Disease Receiving Extracorporeal Membrane Oxygenation Therapy.预测接受体外膜肺氧合治疗的终末期肾病患者的院内死亡率。
Cardiorenal Med. 2025;15(1):164-173. doi: 10.1159/000543434. Epub 2025 Jan 8.
7
Extracorporeal Membrane Oxygenation as Life Support in Neonatal Respiratory Failure: A Single-Center Cohort Study and a Systematic Review.体外膜肺氧合用于新生儿呼吸衰竭的生命支持：一项单中心队列研究及系统评价
Children (Basel). 2024 Nov 26;11(12):1441. doi: 10.3390/children11121441.
8
Effect of extracorporeal membrane oxygenation on mortality rate of aluminum phosphate poisoning: A systematic review and meta-analysis.体外膜肺氧合对磷酸铝中毒死亡率的影响：一项系统评价与Meta分析
J Res Med Sci. 2024 Oct 24;29:62. doi: 10.4103/jrms.jrms_123_24. eCollection 2024.
9
Pharmacokinetic Changes and Influencing Factors of Polymyxin B in Different ECMO Modes.不同体外膜肺氧合模式下多黏菌素B的药代动力学变化及影响因素
Infect Drug Resist. 2024 Dec 25;17:5815-5825. doi: 10.2147/IDR.S486169. eCollection 2024.
10
Enhancing lung transplantation with ECMO: a comprehensive review of mechanisms, outcomes, and future considerations.体外膜肺氧合辅助下增强肺移植：机制、结果及未来考量的全面综述
J Extra Corpor Technol. 2024 Dec;56(4):191-202. doi: 10.1051/ject/2024023. Epub 2024 Dec 20.
本文引用的文献
1
Changes in Von Willebrand factor profile predicts clinical outcomes in patients on mechanical circulatory support.血管性血友病因子水平的变化可预测接受机械循环支持患者的临床结局。
J Card Surg. 2018 Oct;33(10):693-702. doi: 10.1111/jocs.13794. Epub 2018 Sep 10.
2
Hypoxia and Complications of Oxygenation in Extracorporeal Membrane Oxygenation.体外膜肺氧合中的缺氧与氧合并发症
J Cardiothorac Vasc Anesth. 2019 May;33(5):1375-1381. doi: 10.1053/j.jvca.2018.05.028. Epub 2018 Jun 6.
3
Management of vascular complications of extra-corporeal membrane oxygenation.体外膜肺氧合血管并发症的管理
Cardiovasc Diagn Ther. 2018 Jun;8(3):372-377. doi: 10.21037/cdt.2018.01.11.
4
Incidence, Outcome, and Predictors of Intracranial Hemorrhage in Adult Patients on Extracorporeal Membrane Oxygenation: A Systematic and Narrative Review.体外膜肺氧合支持下成年患者颅内出血的发生率、结局及预测因素：一项系统综述与叙述性综述
Front Neurol. 2018 Jul 6;9:548. doi: 10.3389/fneur.2018.00548. eCollection 2018.
5
Optic nerve sheath diameter measured sonographically as non-invasive estimator of intracranial pressure: a systematic review and meta-analysis.超声测量视神经鞘直径作为颅内压无创估计指标的系统评价和荟萃分析。
Intensive Care Med. 2018 Aug;44(8):1284-1294. doi: 10.1007/s00134-018-5305-7. Epub 2018 Jul 17.
6
Meta-Analysis of Peripheral or Central Extracorporeal Membrane Oxygenation in Postcardiotomy and Non-Postcardiotomy Shock.心脏手术后和非心脏手术后休克中外周或中央体外膜肺氧合的荟萃分析。
Ann Thorac Surg. 2019 Jan;107(1):311-321. doi: 10.1016/j.athoracsur.2018.05.063. Epub 2018 Jun 28.
7
A narrative review of the technical standards for extracorporeal life support devices (pumps and oxygenators) in Europe.欧洲体外生命支持设备（泵和氧合器）技术标准的叙述性综述。
Perfusion. 2018 Oct;33(7):553-561. doi: 10.1177/0267659118772452. Epub 2018 May 24.
8
Intracranial hemorrhage in adults on ECMO.接受体外膜肺氧合治疗的成人颅内出血
Perfusion. 2018 May;33(1_suppl):42-50. doi: 10.1177/0267659118766435.
9
Early changes in coagulation profiles and lactate levels in patients with septic shock undergoing extracorporeal membrane oxygenation.接受体外膜肺氧合治疗的感染性休克患者凝血指标和乳酸水平的早期变化
J Thorac Dis. 2018 Mar;10(3):1418-1430. doi: 10.21037/jtd.2018.02.28.
10
The Extracorporeal Life Support Organization Maastricht Treaty for Nomenclature in Extracorporeal Life Support. A Position Paper of the Extracorporeal Life Support Organization.体外生命支持组织关于体外生命支持命名的马斯特里赫特条约。体外生命支持组织的立场文件。
Am J Respir Crit Care Med. 2018 Aug 15;198(4):447-451. doi: 10.1164/rccm.201710-2130CP.
Zotero 插件