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保持耐心:长时间体外膜肺氧合支持,包括全系统切换,预后良好。

Be Patient: Prolonged Extracorporeal Membrane Oxygenation Support Including Full System Switch With Favorable Outcome.

作者信息

Schmandt Mathias, Putensen Christian, Stiehl Tatjana, Wagenpfeil Julia, Schewe Jens-Christian, Ehrentraut Stefan Felix

机构信息

Department of Anesthesiology and Intensive Care Medicine, University Hospital Bonn, Bonn, Germany.

Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Bonn, Germany.

出版信息

J Med Cases. 2022 Oct;13(10):483-490. doi: 10.14740/jmc3979. Epub 2022 Oct 31.

Abstract

Despite tremendous advances in treatment, acute respiratory distress syndrome (ARDS) remains a disease with high mortality (42-48%). Veno-venous extracorporeal membrane oxygenation (VV-ECMO) is often used as a last treatment option, which poses complex problems for the treatment team, especially with prolonged ECMO support. We report an interesting case of a 40-year-old female patient who developed influenza pneumonia leading to ARDS and subsequently requiring ECMO. Due to severe clotting complications, a prolonged ECMO run time with numerous filter changes was required. After a total of 56 days of ECMO therapy, the patient was successfully weaned. Fortunately, further in the course of treatment, complete recovery with was achieved. A distinguishing feature of this case report is the description of a complete ECMO system change and the concurrent use of two ECMO systems for the same patient. Additionally, we provide data on the patient's current health-related quality of life as measured using the World Health Organization Disability Assessment Schedule 2.0.

摘要

尽管在治疗方面取得了巨大进展,但急性呼吸窘迫综合征(ARDS)仍然是一种死亡率很高的疾病(42%-48%)。静脉-静脉体外膜肺氧合(VV-ECMO)通常作为最后的治疗选择,这给治疗团队带来了复杂的问题,尤其是在长时间的ECMO支持下。我们报告了一例有趣的病例,一名40岁女性患者因流感肺炎导致ARDS,随后需要ECMO治疗。由于严重的凝血并发症,需要延长ECMO运行时间并多次更换过滤器。经过总共56天的ECMO治疗,患者成功脱机。幸运的是,在进一步的治疗过程中,患者实现了完全康复。本病例报告的一个显著特点是描述了完整的ECMO系统更换以及为同一患者同时使用两个ECMO系统的情况。此外,我们提供了使用世界卫生组织残疾评估量表2.0测量的患者当前健康相关生活质量的数据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0bdf/9635769/caf9df71565d/jmc-13-483-g001.jpg

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