Huang Weichao, Guo Wenqin, Wang Lili
Department of Critical Care Medicine, Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen 518000, Guangdong, China. Corresponding author: Wang Lili, Email:
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2022 Feb;34(2):211-215. doi: 10.3760/cma.j.cn121430-20210429-00648.
Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is an extracorporeal circulation technique that provides circulatory and oxygenation support, and it is currently used in the treatment of cardiogenic shock (CS), pulmonary embolism, cardiac arrest (CA), and other diseases. However, this technology is still associated with high complications and mortality. The use of predictive scores for risk stratification before VA-ECMO will be helpful to screen the optimal benefiting population, make optimal clinical decisions, and allocate medical resources reasonably. At present, there are few reports about predictive scores for VA-ECMO. This article systematically reviewed the predictive performance of various scoring tools [the survival after venoarterial ECMO (SAVE) score, prediction of cardiogenic shock outcome for acute myocardial infarction (AMI) patients salvaged by VA-ECMO (ENCOURAGE) score, model for end-stage liver disease (MELD-XI) score, post-cardiotomy extracorporeal membrane oxygenation (PC-ECMO) score, the predicting mortality in patients undergoing VA-ECMO after coronary artery bypass grafting (REMEMBER) score, predictors of mortality with VA-ECMO for acute massive pulmonary embolism, extracorporeal cardiopulmonary resuscitation (ECPR) score, the hypothermia outcome prediction after extracorporeal life support (HOPE) score] for patients receiving VA-ECMO to provide reference for clinical treatment.
静脉-动脉体外膜肺氧合（VA-ECMO）是一种提供循环和氧合支持的体外循环技术，目前用于治疗心源性休克（CS）、肺栓塞、心脏骤停（CA）等疾病。然而，该技术仍伴有高并发症和死亡率。在VA-ECMO治疗前使用预测评分进行风险分层，将有助于筛选出最佳受益人群，做出最佳临床决策，并合理分配医疗资源。目前，关于VA-ECMO预测评分的报道较少。本文系统评价了各种评分工具[静脉-动脉ECMO后生存率（SAVE）评分、VA-ECMO挽救的急性心肌梗死（AMI）患者心源性休克结局预测（ENCOURAGE）评分、终末期肝病模型（MELD-XI）评分、心脏术后体外膜肺氧合（PC-ECMO）评分、冠状动脉旁路移植术后接受VA-ECMO患者的死亡率预测（REMEMBER）评分、急性大面积肺栓塞VA-ECMO患者的死亡率预测指标、体外心肺复苏（ECPR）评分、体外生命支持后低温结局预测（HOPE）评分]对接受VA-ECMO患者的预测性能，为临床治疗提供参考。
