Egan T M, Duffin J, Glynn M F, Todd T R, DeMajo W, Murphy E, Fox L, Cooper J D
Toronto General Hospital, Canada.
Chest. 1988 Oct;94(4):681-7. doi: 10.1378/chest.94.4.681.
In the last ten years, 17 patients with respiratory failure refractory to standard ventilator therapy have been treated with extracorporeal membrane oxygenation (ECMO) at the Toronto General Hospital. One patient was treated with ECMO twice. Four perfusions were veno-arterial, the remainder veno-venous. Perfusions ranged from 1 1/2 to 19 days, with a mean of six days. Ten patients died during treatment or soon after it was discontinued. Eight patients improved enough to allow resumption of standard ventilation, and four patients recovered sufficiently to have normal arterial blood gas levels on room air. Three are long-term survivors. Multiple surgical procedures have been performed successfully during use of ECMO including lung lavage, open lung biopsy and three lung transplants. Major complications include hemorrhagic diatheses and sepsis. The technique involves a substantial commitment of time and personnel but remains a tenable option for presumed reversible life-threatening respiratory failure.
在过去十年中，多伦多综合医院对17例标准通气治疗无效的呼吸衰竭患者进行了体外膜肺氧合（ECMO）治疗。1例患者接受了两次ECMO治疗。4次灌注为静脉-动脉转流，其余为静脉-静脉转流。灌注时间从1.5天至19天不等，平均为6天。10例患者在治疗期间或治疗停止后不久死亡。8例患者病情改善到足以恢复标准通气，4例患者恢复到在室内空气中动脉血气水平正常。3例为长期存活者。在使用ECMO期间成功进行了多项外科手术，包括肺灌洗、开胸肺活检和3例肺移植。主要并发症包括出血倾向和败血症。该技术需要大量的时间和人员投入，但对于假定为可逆的危及生命的呼吸衰竭来说，仍然是一个可行的选择。
