Choi Min Suk, Sung Kiick, Cho Yang Hyun
Department of Thoracic and Cardiovascular Surgery, Dongguk University Ilsan Hospital, Dongguk University School of Medicine, Goyang, Korea.
Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Korean Circ J. 2019 Aug;49(8):657-677. doi: 10.4070/kcj.2019.0188.
Extracorporeal membrane oxygenation (ECMO) is a technique that uses a pump to drain blood from a body, circulate blood through a membrane lung, and return the oxygenated blood back into the body. Venoarterial (VA) ECMO is a simplified version of the heart-lung machine that assists native pulmonary and/or cardiac function. VA ECMO is composed of a drainage cannula in the venous system and a return cannula in the arterial system. Because VA ECMO can increase tissue perfusion by increasing the arterial blood flow, it is used to treat medically refractory cardiogenic shock or cardiac arrest. VA ECMO has a distinct physiology that is referred to as differential flows. It can cause several complications such as left ventricular distension with pulmonary edema, distal limb ischemia, bleeding, and thromboembolism. Physicians who are using this technology should be knowledgeable on the prevention and management of these complications. We review the basic physiology of VA ECMO, the mechanism of complications, and the simple management of VA ECMO.
体外膜肺氧合（ECMO）是一种利用泵从体内引流血液，使血液通过膜肺循环，然后将氧合后的血液回输到体内的技术。静脉-动脉（VA）ECMO是心肺机的简化版本，可辅助自身肺和/或心脏功能。VA ECMO由静脉系统中的引流插管和动脉系统中的回输插管组成。由于VA ECMO可通过增加动脉血流量来增加组织灌注，因此用于治疗药物难治性心源性休克或心脏骤停。VA ECMO具有一种独特的生理学现象，称为分流。它可导致多种并发症，如左心室扩张伴肺水肿、肢体远端缺血、出血和血栓栓塞。使用该技术的医生应了解这些并发症的预防和处理方法。我们回顾了VA ECMO的基本生理学、并发症机制以及VA ECMO的简单管理方法。
