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成人危急气道阻塞时的体外氧合技术:综述。

Extracorporeal Oxygenation Techniques in Adult Critical Airway Obstruction: A Review.

机构信息

Department of Anesthesiology and Intensive Care Medicine, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic.

Department of Anaesthesia, Antrim Area Hospital, Antrim, United Kingdom.

出版信息

Prague Med Rep. 2021;122(2):61-72. doi: 10.14712/23362936.2021.7.

Abstract

Extracorporeal life support has been increasingly utilized in different clinical settings to manage either critical respiratory or heart failure. Complex airway surgery with significant or even total perioperative airway obstruction represents an indication for this technique to prevent/overcome a critical period of severe hypoxaemia, hypoventilation, and/or apnea. This review summarizes the current published scientific evidence on the utility of extracorporeal respiratory support in airway obstruction associated with hypoxaemia, describes the available methods, their clinical indications, and possible limitations. Extracorporeal membrane oxygenation using veno-arterial or veno-venous mode is most commonly employed in such scenarios caused by endoluminal, external, or combined obstruction of the trachea and main bronchi.

摘要

体外生命支持已越来越多地用于不同的临床环境中,以治疗严重的呼吸或心力衰竭。伴有严重甚至完全围手术期气道阻塞的复杂气道手术,是应用该技术预防/克服严重低氧血症、低通气和/或呼吸暂停这一关键时期的指征。本文综述了目前关于体外呼吸支持在与低氧血症相关气道阻塞中的应用的相关科学证据,描述了现有的方法、其临床适应证和可能的局限性。体外膜氧合采用静脉-动脉或静脉-静脉模式,最常用于由气管和主支气管腔内、外或联合阻塞引起的此类情况。

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