Yan Shujie, Lou Song, Zhao Yu, Liu Gang, Ji Bingyang
Department of Cardiopulmonary Bypass, State Key Laboratory of Cardiovascular Medicine, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
New Era Stroke Care and Research Institute, The PLA Rocket Force General Hospital, Beijing, China.
Perfusion. 2021 Jan;36(1):97-99. doi: 10.1177/0267659120918471. Epub 2020 May 19.
Air in extracorporeal membrane oxygenation circuit may lead to deleterious consequence.
Three cases of air in extracorporeal membrane oxygenation were presented. Air was introduced from right jugular venous sheath during percutaneous septal repair, pulmonary artery catheter during intensive care unit, and sewing holes on atrial wall during surgery respectively. Accidents in Case 2 and Case 3 were successfully managed, while Case 1 was suspected of cerebral air embolism through transseptal right-to-left shunt.
With extracorporeal membrane oxygenation being widely applied in more clinical settings, especially in catheterization lab, risks of air in extracorporeal membrane oxygenation increase. More attention should be paid to patients with communication between right and left heart system, especially in situations when venous accesses' exposure to air could not be avoided.
Air in the extracorporeal membrane oxygenation circuit should never be overemphasized, especially during special procedures.
体外膜肺氧合回路中的空气可能会导致有害后果。
介绍了3例体外膜肺氧合中出现空气的病例。空气分别在经皮房间隔修复期间从右颈静脉鞘进入、在重症监护病房期间从肺动脉导管进入以及在手术期间从心房壁的缝合孔进入。病例2和病例3中的意外情况得到了成功处理，而病例1被怀疑通过经房间隔右向左分流发生了脑空气栓塞。
随着体外膜肺氧合在更多临床环境中广泛应用，尤其是在导管室，体外膜肺氧合中空气的风险增加。对于左右心系统存在交通的患者应给予更多关注，尤其是在无法避免静脉通路暴露于空气的情况下。
体外膜肺氧合回路中的空气问题绝不应被忽视，尤其是在特殊操作过程中。
