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静脉-静脉体外膜肺氧合期间的出血:预防与治疗

Bleeding During Veno-Venous ECMO: Prevention and Treatment.

作者信息

Kalbhenn Johannes, Zieger Barbara

机构信息

Department of Anesthesiology and Critical Care, Faculty of Medicine, Medical Center-University of Freiburg, Freiburg im Breisgau, Germany.

Division of Pediatric Hematology and Oncology, Department of Pediatrics and Adolescent Medicine, Faculty of Medicine, Medical Center-University of Freiburg, Freiburg im Breisgau, Germany.

出版信息

Front Med (Lausanne). 2022 May 23;9:879579. doi: 10.3389/fmed.2022.879579. eCollection 2022.

Abstract

Veno-venous extracorporeal membrane oxygenation (vvECMO) has become a routine treatment for severe lung failure in specialized centers. Spontaneous bleeding complications, however, are observed in 30-60% of patients during vvECMO treatment. Bleeding increases mortality by factors 2-3. Anticoagulation in combination with several acquired bleeding disorders caused by the mechanical pump and the foreign layer of the extracorporeal system contribute to the risk of bleeding. In this review, the mechanisms of the underlying pathologies and the route from diagnosis to treatment are described.

摘要

静脉-静脉体外膜肺氧合(vvECMO)已成为专业中心治疗严重肺衰竭的常规疗法。然而,在vvECMO治疗期间,30%-60%的患者会出现自发性出血并发症。出血使死亡率增加2至3倍。抗凝治疗以及由机械泵和体外系统异物层引发的多种获得性出血性疾病共同增加了出血风险。在本综述中,描述了潜在病理机制以及从诊断到治疗的流程。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c178/9168900/0157cdec812a/fmed-09-879579-g0001.jpg

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