Banga Sandeep, Challa Abhiram, Patel Avani R, Singh Shantanu, Emani Vamsi K
Cardiology, West Virginia University School of Medicine, Morgantown, USA.
Internal Medicine, West Virginia University School of Medicine, Morgantown, USA.
Cureus. 2019 Sep 20;11(9):e5709. doi: 10.7759/cureus.5709.
Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) plays a crucial role in the management of patients with refractory cardiac and pulmonary dysfunction by providing temporary mechanical hemodynamic and respiratory support. However, the paucity of guidelines on indications for administering it and the failure to timely initiate VA-ECMO often result in a high in-hospital mortality rate and poor six-month outcomes after VA-ECMO deployment. Due to ethical issues, randomized controlled studies with VA-ECMO have not been conducted so that no recommended evidence-based guidelines exist for VA-ECMO patient-selection criteria. Therefore, the indication for administering the device depends solely on expert opinion after reviewing the literature. We conducted a review of the current literature to better understand and classify the need for proper patient selection, including proven indications for VA-ECMO.
静脉-动脉体外膜肺氧合（VA-ECMO）通过提供临时的机械血流动力学和呼吸支持，在难治性心肺功能障碍患者的管理中发挥着关键作用。然而，关于VA-ECMO使用指征的指南匮乏，以及未能及时启动VA-ECMO，常常导致住院死亡率高，且VA-ECMO应用后六个月的预后不佳。由于伦理问题，尚未进行VA-ECMO的随机对照研究，因此不存在基于证据的VA-ECMO患者选择标准推荐指南。因此，该设备的使用指征完全取决于文献综述后的专家意见。我们对当前文献进行了综述，以更好地理解和分类合适患者选择的必要性，包括VA-ECMO的已证实指征。
