Song Huapei, Yuan Zhiqiang, Peng Yizhi, Luo Gaoxing
State Key Laboratory of Trauma, Burn and Combined Injury, Institute of Burn Research, Southwest Hospital, Third Military Medical University (Army Medical University), 30 Gaotanyan Street, Chongqing 400038, China.
Burns Trauma. 2021 Jun 23;9:tkab017. doi: 10.1093/burnst/tkab017. eCollection 2021.
Severe burns often cause various systemic complications and multiple organ dysfunction syndrome, which is the main cause of death. The lungs and kidneys are vulnerable organs in patients with multiple organ dysfunction syndrome after burns. Extracorporeal membrane oxygenation (ECMO) and continuous renal replacement therapy (CRRT) have been gradually applied in clinical practice and are beneficial for severe burn patients with refractory respiratory failure or renal dysfunction. However, the literature on ECMO combined with CRRT for the treatment of severe burns is limited. Here, we focus on the current status of ECMO combined with CRRT for the treatment of severe burns and the associated challenges, including the timing of treatment, nutrition support, heparinization and wound management, catheter-related infection and drug dosing in CRRT. With the advancement of medical technology, ECMO combined with CRRT will be further optimized to improve the outcomes of patients with severe burns.
严重烧伤常导致各种全身并发症和多器官功能障碍综合征,这是主要的死亡原因。肺和肾是烧伤后多器官功能障碍综合征患者的易损器官。体外膜肺氧合(ECMO)和连续性肾脏替代治疗(CRRT)已逐渐应用于临床实践,对伴有难治性呼吸衰竭或肾功能不全的严重烧伤患者有益。然而,关于ECMO联合CRRT治疗严重烧伤的文献有限。在此,我们聚焦于ECMO联合CRRT治疗严重烧伤的现状及相关挑战,包括治疗时机、营养支持、肝素化及创面处理、CRRT中的导管相关感染和药物剂量等。随着医学技术的进步,ECMO联合CRRT将进一步优化,以改善严重烧伤患者的预后。