急诊科的体外膜肺氧合

Extracorporeal Membrane Oxygenation in the Emergency Department.

作者信息

Badulak Jenelle H, Shinar Zachary

机构信息

Division of Pulmonary, Critical Care and Sleep Medicine, Department of Emergency Medicine, University of Washington, Harborview Medical Center, Box 359702, 325 Ninth Avenue, Seattle, WA 98104-2499, USA.

Department of Emergency Medicine, Sharp Memorial Hospital, 7901 Frost Street, San Diego, CA 92130, USA. Electronic address: https://twitter.com/ZackShinar.

出版信息

Emerg Med Clin North Am. 2020 Nov;38(4):945-959. doi: 10.1016/j.emc.2020.06.015. Epub 2020 Sep 9.

DOI:10.1016/j.emc.2020.06.015

PMID:32981628

Abstract

Extracorporeal membrane oxygenation (ECMO) is a mechanical way to provide oxygenation, ventilation, and perfusion to patients with severe cardiopulmonary failure. Extracorporeal cardiopulmonary resuscitation (ECPR) describes the use of ECMO during cardiac arrest. ECPR requires an organized approach to resuscitation, cannula insertion, and pump initiation. Selecting the right patients for ECPR is an important aspect of successful programs. A solid understanding of the components of the ECMO circuit is critical to troubleshooting problems. Current evidence suggests a substantial benefit of ECPR compared with traditional CPR for refractory cardiac arrest but is limited by lack of randomized trials to date.

摘要

体外膜肺氧合（ECMO）是一种为严重心肺功能衰竭患者提供氧合、通气和灌注的机械方法。体外心肺复苏（ECPR）指在心脏骤停期间使用ECMO。ECPR需要有组织的复苏、插管和启动泵的方法。为ECPR选择合适的患者是成功实施该方案的一个重要方面。扎实了解ECMO回路的组成部分对于解决问题至关重要。目前的证据表明，与传统心肺复苏相比，ECPR对难治性心脏骤停有显著益处，但迄今为止因缺乏随机试验而受到限制。