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清醒体外膜肺氧合联合持续肾脏替代治疗用于重度化学性吸入性肺损伤

"Awake" Extracorporeal Membrane Oxygenation Combined With Continuous Renal Replacement Therapy For the Treatment of Severe Chemical Gas Inhalation Lung Injury.

机构信息

Department of Emergency Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, China.

出版信息

J Burn Care Res. 2020 Jul 3;41(4):908-912. doi: 10.1093/jbcr/iraa043.

Abstract

Lung injury caused by chemical gas inhalation is a common clinically severe disease that very easily progresses to acute respiratory distress syndrome (ARDS). Traditional respiratory support consists mainly of mechanical ventilation, but the prognosis of this condition is still poor. "Awake" extracorporeal membrane oxygenation (ECMO) maintains oxygenation, improves ventilation, adequately allows the injured lungs to rest, and avoids complications associated with sedation, intubation, and mechanical ventilation. Continuous renal replacement therapy (CRRT) can provide better fluid management and reduce pulmonary edema. Herein, we describe the case of a patient with severe chemical gas inhalation lung injury who failed to respond to traditional mechanical ventilation and was subsequently treated with awake ECMO combined with CRRT.

摘要

吸入化学性气体导致的肺损伤是一种常见的临床危重症,极易进展为急性呼吸窘迫综合征(ARDS)。传统的呼吸支持主要包括机械通气,但这种情况下的预后仍然较差。“清醒”状态下的体外膜氧合(ECMO)可维持氧合,改善通气,使受损的肺充分休息,并避免镇静、插管和机械通气相关的并发症。持续肾脏替代治疗(CRRT)可以提供更好的液体管理,减少肺水肿。在此,我们描述了 1 例严重化学性气体吸入性肺损伤患者的病例,该患者对传统机械通气无反应,随后接受了清醒 ECMO 联合 CRRT 治疗。

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