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体外膜肺氧合在血液系统恶性肿瘤患者中的应用:文献综述

The Utility of Extracorporeal Membrane Oxygenation in Patients With Hematologic Malignancies: A Literature Review.

作者信息

Tathineni Praveena, Pandya Mauna, Chaar Bassem

机构信息

Internal Medicine, University of Illinois at Chicago/Advocate Christ Medical Center, Chicago, USA.

Hematology and Oncology, Advocate Christ Medical Center, Chicago, USA.

出版信息

Cureus. 2020 Jul 10;12(7):e9118. doi: 10.7759/cureus.9118.

Abstract

Extracorporeal membrane oxygenation (ECMO) is used to provide respiratory and/or circulatory support for critically ill patients. In people suffering from hematologic malignancies (HMs), acute respiratory failure often necessitates intensive care. Whereas initial studies reported that these patients generally have poor outcomes, studies conducted within the last 10 years have shown that ECMO is quite beneficial for patients with HMs. This review showcases data from 2010 to 2019 demonstrating the utility of ECMO in cancer patients. Retrospective studies revealed long-term disease-free survival, particularly when ECMO served as a bridge through chemotherapy. Case reports suggested strong evidence of mortality benefit from ECMO, especially in patients with aggressive lymphomas. However, a systematic approach is needed to better quantify and validate these findings. Studies with larger sample size and prospective cohorts are needed to help create well-defined guidelines for physicians approaching the treatment of cancer patients on ECMO.

摘要

体外膜肺氧合(ECMO)用于为重症患者提供呼吸和/或循环支持。在患有血液系统恶性肿瘤(HM)的患者中,急性呼吸衰竭往往需要重症监护。尽管早期研究报告称这些患者的总体预后较差,但过去10年进行的研究表明,ECMO对HM患者非常有益。本综述展示了2010年至2019年的数据,证明了ECMO在癌症患者中的效用。回顾性研究显示了长期无病生存,特别是当ECMO作为化疗的桥梁时。病例报告表明有强有力的证据支持ECMO可带来生存获益,尤其是在侵袭性淋巴瘤患者中。然而,需要一种系统的方法来更好地量化和验证这些发现。需要进行更大样本量的研究和前瞻性队列研究,以帮助为治疗接受ECMO的癌症患者的医生制定明确的指南。

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