Department of Medicine, Division of Pulmonary and Critical Care, Program in Trauma, University of Maryland School of Medicine, Baltimore, Maryland.
Department of Anesthesiology, Program in Trauma, University of Maryland School of Medicine, Baltimore, Maryland.
Shock. 2021 Jun 1;55(6):742-751. doi: 10.1097/SHK.0000000000001677.
Extracorporeal life support (ECLS) is a support modality for patients with severe acute respiratory distress syndrome (ARDS) who have failed conventional treatments including low tidal volume ventilation, prone positioning, and neuromuscular blockade. In addition, ECLS can be used for hemodynamic support for patients with cardiogenic shock or following cardiac arrest. Injured patients may also require ECLS support for ARDS and other indications. We review the use of ECLS for ARDS patients, trauma patients, cardiogenic shock patients, and post-cardiac arrest patients. We then describe how these principles are applied in the management of the novel coronavirus disease 2019 pandemic. Indications, predictors, procedural considerations, and post-cannulation management strategies are discussed.
体外生命支持（ECLS）是一种支持方式，适用于那些常规治疗（包括低潮气量通气、俯卧位和神经肌肉阻滞）失败的严重急性呼吸窘迫综合征（ARDS）患者。此外，ECLS 还可用于心源性休克或心脏骤停后的血流动力学支持。受伤的患者也可能需要 ECLS 支持来治疗 ARDS 和其他适应症。我们回顾了 ECLS 在 ARDS 患者、创伤患者、心源性休克患者和心脏骤停后患者中的应用。然后，我们描述了这些原则如何应用于新型冠状病毒病 2019 大流行的管理。讨论了适应证、预测因素、程序注意事项和插管后管理策略。
