Department of Cardiothoracic Surgery, Zhongshan Hospital of Sun Yat-Sen University (Zhongshan People's Hospital), Zhongshan, Guangdong, China (mainland).
Department of Anesthesiology, Zhongshan Hospital of Sun Yat-Sen University (Zhongshan City People's Hospital), Zhongshan, Guangdong, China (mainland).
Med Sci Monit. 2021 Nov 2;27:e931842. doi: 10.12659/MSM.931842.
BACKGROUND Extracorporeal membrane oxygenation (ECMO) plays an important role in thoracic surgery. This retrospective study from a single center aimed to evaluate patient outcomes from the use of perioperative ECMO in 22 patients undergoing thoracic surgery during an 8-year period. MATERIAL AND METHODS Data were collected retrospectively from 22 patients who received ECMO (veno-arterial and veno-venous ECMO) as perioperative treatment during general thoracic surgery from January 2012 to October 2020. Patients required ECMO due to perioperative cardiopulmonary resuscitation (CPR) (2 cases), perioperative pulmonary embolism (PE) (2 cases), lung transplant (4 cases), undergoing complicated thoracic surgery (5 cases), postoperative acute respiratory distress syndrome (ARDS) (6 cases), and thoracic trauma (3 cases). RESULTS Veno-arterial ECMO was used for circulatory support in 13 cases and veno-venous ECMO was used for respiratory support in 9 cases. The average ECMO support time was 71.6±42.4 h. Twenty patients (90.9%) were successfully decannulated and 17 (77.2%) survived to discharge. Complications included severe hemorrhage (3/22 patients, 13.6%), sepsis (3/22, 13.6%), and destruction of blood cells (1/22, 4.5%). There were no significant differences in survival rates between patients receiving pre- or postoperative ECMO (P=0.135) or between veno-venous ECMO (V-V ECMO) and veno-arterial ECMO (V-A ECMO) (P=0.550). CONCLUSIONS The findings from this small retrospective study from a single center showed that perioperative ECMO improved cardiac and respiratory function in patients undergoing thoracic surgery. Optimal results require surgeons to have an understanding of the indications and ability to control the complications of ECMO.
体外膜肺氧合（ECMO）在胸外科中起着重要作用。本项来自单中心的回顾性研究旨在评估 8 年间 22 例行胸外科手术患者围手术期使用 ECMO 的患者结局。
从 2012 年 1 月至 2020 年 10 月期间因围手术期心肺复苏（CPR）（2 例）、围手术期肺栓塞（PE）（2 例）、肺移植（4 例）、复杂胸外科手术（5 例）、术后急性呼吸窘迫综合征（ARDS）（6 例）和胸部创伤（3 例）而接受 ECMO（静脉-动脉和静脉-静脉 ECMO）作为围手术期治疗的 22 例患者中回顾性收集数据。
13 例患者使用静脉-动脉 ECMO 进行循环支持，9 例患者使用静脉-静脉 ECMO 进行呼吸支持。平均 ECMO 支持时间为 71.6±42.4 h。20 例（90.9%）患者成功脱机，17 例（77.2%）患者存活至出院。并发症包括严重出血（3/22 例，13.6%）、脓毒症（3/22 例，13.6%）和血细胞破坏（1/22 例，4.5%）。接受术前或术后 ECMO 的患者生存率无显著差异（P=0.135），或静脉-静脉 ECMO（V-V ECMO）与静脉-动脉 ECMO（V-A ECMO）之间无显著差异（P=0.550）。
来自单中心的这项小回顾性研究结果表明，围手术期 ECMO 改善了行胸外科手术患者的心脏和呼吸功能。最佳结果需要外科医生了解 ECMO 的适应证和控制 ECMO 并发症的能力。
