儿科及新生儿体外生命支持：现状与持续发展
Pediatric and neonatal extracorporeal life support: current state and continuing evolution.
作者信息
Fallon Brian P, Gadepalli Samir K, Hirschl Ronald B
机构信息
Department of Surgery, ECLS Laboratory, B560 MSRB II/SPC 5686, Michigan Medicine, University of Michigan, 1150 W. Medical Center Drive, Ann Arbor, MI, 48109, USA.
Department of Surgery, Section of Pediatric Surgery, University of Michigan, Ann Arbor, MI, USA.
出版信息
Pediatr Surg Int. 2021 Jan;37(1):17-35. doi: 10.1007/s00383-020-04800-2. Epub 2021 Jan 1.
Abstract
The use of extracorporeal life support (ECLS) for the pediatric and neonatal population continues to grow. At the same time, there have been dramatic improvements in the technology and safety of ECLS that have broadened the scope of its application. This article will review the evolving landscape of ECLS, including its expanding indications and shrinking contraindications. It will also describe traditional and hybrid cannulation strategies as well as changes in circuit components such as servo regulation, non-thrombogenic surfaces, and paracorporeal lung-assist devices. Finally, it will outline the modern approach to managing a patient on ECLS, including anticoagulation, sedation, rehabilitation, nutrition, and staffing.
摘要
体外生命支持（ECLS）在儿科和新生儿群体中的应用持续增加。与此同时，ECLS的技术和安全性有了显著提高，这拓宽了其应用范围。本文将回顾ECLS不断演变的情况，包括其不断扩大的适应证和不断缩小的禁忌证。还将描述传统和混合插管策略以及回路组件的变化，如伺服调节、非血栓形成表面和体外肺辅助装置。最后，将概述对接受ECLS治疗的患者的现代管理方法，包括抗凝、镇静、康复、营养和人员配备。
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