Moreau Anthony, Levy Bruno, Annoni Filippo, Lorusso Roberto, Su Fuhong, Belliato Mirko, Taccone Fabio Silvio
Department of Intensive Care, Hôpital Universitaire de Bruxelles (HUB), Brussels, Belgium.
Laboratoire Expérimental des Soins Intensifs, Université Libre de Bruxelles (ULB), Brussels, Belgium.
Resusc Plus. 2023 Jan 28;13:100360. doi: 10.1016/j.resplu.2023.100360. eCollection 2023 Mar.
Despite venovenous or venoarterial extracorporeal membrane oxygenation (ECMO) being increasingly used in patients with severe acute respiratory disease syndrome, severe cardiogenic shock, and refractory cardiac arrest, mortality rates still remain high mainly because of the severity of the underlying disease and the numerous complications associated with initiation of ECMO. Induced hypothermia might minimize several pathological pathways present in patients requiring ECMO; even though numerous studies conducted in the experimental setting have reported promising results, there are currently no recommendations suggesting the routine use of this therapy in patients requiring ECMO. In this review, we summarized the existing evidence on the use of induced hypothermia in patients requiring ECMO. Induced hypothermia was a feasible and relatively safe intervention in this setting; however, the effects on clinical outcomes remain uncertain. Whether controlled normothermia has an impact on these patients compared with no temperature control remains unknown. Further randomized controlled trials are required to better understand the role and impact of such therapy in patients requiring ECMO according to the underlying disease.
尽管静脉-静脉或静脉-动脉体外膜肺氧合（ECMO）在患有严重急性呼吸窘迫综合征、严重心源性休克和难治性心脏骤停的患者中使用越来越多，但死亡率仍然很高，主要原因是基础疾病的严重性以及与启动ECMO相关的众多并发症。诱导性低温可能会使需要ECMO的患者中存在的几种病理途径降至最低；尽管在实验环境中进行的大量研究报告了有希望的结果，但目前尚无建议表明在需要ECMO的患者中常规使用这种疗法。在本综述中，我们总结了关于在需要ECMO的患者中使用诱导性低温的现有证据。在这种情况下，诱导性低温是一种可行且相对安全的干预措施；然而，对临床结局的影响仍不确定。与不进行体温控制相比，控制性正常体温是否对这些患者有影响仍不清楚。需要进一步的随机对照试验，以根据基础疾病更好地了解这种疗法在需要ECMO的患者中的作用和影响。
