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体外膜肺氧合用于心源性休克及作为心脏移植的过渡手段

ECMO in cardiogenic shock and bridge to heart transplant.

作者信息

Chakaramakkil Mathew Jose, Sivathasan Cumaraswamy

机构信息

Department of Cardiothoracic Surgery, National Heart Centre Singapore, 5 Hospital drive, Singapore, 169609 Singapore.

出版信息

Indian J Thorac Cardiovasc Surg. 2021 Apr;37(Suppl 2):319-326. doi: 10.1007/s12055-020-00923-2. Epub 2020 Feb 11.

DOI:10.1007/s12055-020-00923-2
PMID:33967452
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8062637/
Abstract

PURPOSE

The aim of this review is to discuss the role of extracorporeal membrane oxygenation (ECMO) in cardiogenic shock and its use to bridge patients to heart transplantation.

METHODS AND RESULTS

Consideration of published literature reveals indications for ECMO in cardiogenic shock and tools for patient selection, adequate evidence of its efficacy, its advantages when compared with other temporary mechanical circulatory support devices and details of its use as a bridge to decision, bridge to recovery, bridge to bridge (durable ventricular assist device) and bridge to heart transplant.

CONCLUSION

ECMO is invaluable in treating patients with medically refractory profound cardiogenic shock and allows for cardiac recovery or planning for permanent heart replacement treatments.

摘要

目的

本综述旨在探讨体外膜肺氧合（ECMO）在心源性休克中的作用及其作为患者心脏移植过渡手段的应用。

方法与结果

对已发表文献的考量揭示了ECMO在心源性休克中的适应证、患者选择工具、其疗效的充分证据、与其他临时机械循环支持装置相比的优势，以及其作为决策过渡、恢复过渡、桥接过渡（耐用心室辅助装置）和心脏移植过渡的使用细节。

结论

ECMO在治疗药物难治性严重心源性休克患者方面具有重要价值，并有助于心脏恢复或规划永久性心脏替代治疗。

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1
ECMO in cardiogenic shock and bridge to heart transplant.体外膜肺氧合用于心源性休克及作为心脏移植的过渡手段
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2
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J Heart Lung Transplant. 2024 Jan;43(1):77-84. doi: 10.1016/j.healun.2023.06.016. Epub 2023 Jun 30.
2
Veno-Arterial Extracorporeal Membrane Oxygenation as a Bridge to Heart Transplant-Change of Paradigm.静脉-动脉体外膜肺氧合作为心脏移植桥梁——范式的转变。
J Clin Med. 2022 Nov 30;11(23):7101. doi: 10.3390/jcm11237101.

本文引用的文献

1
SCAI clinical expert consensus statement on the classification of cardiogenic shock: This document was endorsed by the American College of Cardiology (ACC), the American Heart Association (AHA), the Society of Critical Care Medicine (SCCM), and the Society of Thoracic Surgeons (STS) in April 2019.美国心脏病学会（ACC）、美国心脏协会（AHA）、重症医学会（SCCM）和胸外科医师学会（STS）于 2019 年 4 月共同发布了心血管造影协会（SCAI）关于心源性休克分类的临床专家共识声明。
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2019 EACTS Expert Consensus on long-term mechanical circulatory support.2019 年 EACTS 专家共识：长期机械循环支持
Eur J Cardiothorac Surg. 2019 Aug 1;56(2):230-270. doi: 10.1093/ejcts/ezz098.
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OPTN/SRTR 2017 Annual Data Report: Heart.OPTN/SRTR 2017 年度数据报告：心脏。
Am J Transplant. 2019 Feb;19 Suppl 2:323-403. doi: 10.1111/ajt.15278.
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Predicting mortality in patients undergoing VA-ECMO after coronary artery bypass grafting: the REMEMBER score.预测冠状动脉旁路移植术后行 VA-ECMO 患者的死亡率：REMMEMBER 评分。
Crit Care. 2019 Jan 11;23(1):11. doi: 10.1186/s13054-019-2307-y.
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Ischemic and hemorrhagic brain injury during venoarterial-extracorporeal membrane oxygenation.静脉-动脉体外膜肺氧合期间的缺血性和出血性脑损伤。
Ann Intensive Care. 2018 Dec 20;8(1):129. doi: 10.1186/s13613-018-0475-6.
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Predictors of Survival for Patients with Acute Decompensated Heart Failure Requiring Extra-Corporeal Membrane Oxygenation Therapy.需要体外膜肺氧合治疗的急性失代偿性心力衰竭患者的生存预测因素。
ASAIO J. 2019 Nov/Dec;65(8):781-787. doi: 10.1097/MAT.0000000000000898.
7
Extracorporeal membrane oxygenation as a direct bridge to heart transplantation in adults.体外膜肺氧合作为成人心脏移植的直接桥接。
J Thorac Cardiovasc Surg. 2018 Apr;155(4):1607-1618.e6. doi: 10.1016/j.jtcvs.2017.10.152. Epub 2017 Dec 21.
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Predictors of survival and ability to wean from short-term mechanical circulatory support device following acute myocardial infarction complicated by cardiogenic shock.急性心肌梗死后合并心源性休克患者短期机械循环支持装置撤机的生存预测因素和能力。
Eur Heart J Acute Cardiovasc Care. 2018 Dec;7(8):755-765. doi: 10.1177/2048872617740834. Epub 2017 Nov 2.
9
Clinical outcomes of temporary mechanical circulatory support as a direct bridge to heart transplantation: a nationwide Spanish registry.作为直接心脏移植桥接的临时机械循环支持的临床结果：一项全国性的西班牙注册研究。
Eur J Heart Fail. 2018 Jan;20(1):178-186. doi: 10.1002/ejhf.956. Epub 2017 Sep 26.
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Contemporary Management of Cardiogenic Shock: A Scientific Statement From the American Heart Association.当代心源性休克管理：美国心脏协会的科学声明
Circulation. 2017 Oct 17;136(16):e232-e268. doi: 10.1161/CIR.0000000000000525. Epub 2017 Sep 18.