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COVID-19患者的体外膜肺氧合治疗:来自苏黎世的经验。

ECMO therapy in COVID-19: An experience from Zurich.

作者信息

Sromicki Juri, Schmiady Martin, Maisano Francesco, Mestres Carlos A

机构信息

Clinic of Cardiac Surgery, University Hospital Zürich, Zürich, Switzerland.

Department of Cardiothoracic Surgery, The University of the Free State, Bloemfontein, South Africa.

出版信息

J Card Surg. 2021 May;36(5):1707-1712. doi: 10.1111/jocs.15147. Epub 2020 Oct 30.

Abstract

BACKGROUND

The current coronavirus disease 2019 (COVID-19) pandemic has a huge impact on society and the economy and represents one of the biggest challenges for healthcare systems all over the world. Reports from healthcare institutions in different countries show a variety of crisis exit strategies.

METHODS

The following is a review and update of the situation and crisis management in Zürich and Switzerland with a special focus on the impact on the cardiac surgery program and extracorporeal membrane oxygenation (ECMO)-therapy in COVID-19.

RESULTS

Regional and national measures had avoided the collapse of the health system in Switzerland. There was a reduction of over 50% of the surgical and transcatheter caseload during the first wave of the pandemic. Twenty-three ECMO devices, 150 oxygenators, and more than 300 different cannulas were at our disposal. Between March and May 2020, nine COVID-19 patients were treated by us with ECMO-therapy. Three patients were transported by us from distant institutions. Median age at ECMO implantation was 59 years. Two patients died on support.

CONCLUSIONS

Measures to prevent a collapse of the healthcare system were effective. Our local ECMO-Program on the ongoing COVID-19 pandemic has proven to be a useful tool to control mortality and organ failure in critically ill patients.

摘要

背景

当前的2019冠状病毒病(COVID-19)大流行对社会和经济产生了巨大影响,是全球医疗系统面临的最大挑战之一。不同国家医疗机构的报告显示了各种危机应对策略。

方法

以下是对苏黎世和瑞士的情况及危机管理的回顾与更新,特别关注COVID-19对心脏外科手术项目和体外膜肺氧合(ECMO)治疗的影响。

结果

地区和国家措施避免了瑞士卫生系统的崩溃。在疫情第一波期间,外科手术和经导管病例量减少了50%以上。我们有23台ECMO设备、150个氧合器和300多种不同的插管可供使用。2020年3月至5月期间,我们用ECMO治疗了9例COVID-19患者。我们从远处机构转运了3例患者。ECMO植入时的中位年龄为59岁。2例患者在支持治疗期间死亡。

结论

防止医疗系统崩溃的措施是有效的。我们针对持续的COVID-19大流行开展的本地ECMO项目已被证明是控制危重症患者死亡率和器官衰竭的有用工具。

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