Cai Jinxia, Abudou Halidan, Chen Yuansen, Wang Haiwang, Wang Yiping, Li Wenli, Li Duo, Niu Yanxiang, Chen Xin, Liu Yanqing, Li Yongmao, Liu Ziquan, Meng Xiangyan, Fan Haojun
Institute of Disaster and Emergency Medicine, Tianjin University, Tianjin, China.
Wenzhou Safety (Emergency) Institute, Tianjin University, Wenzhou, China.
Front Med (Lausanne). 2023 Mar 30;10:1117214. doi: 10.3389/fmed.2023.1117214. eCollection 2023.
Extracorporeal membrane oxygenation (ECMO) played an important role in the treatment of patients with critical care such as cardiac arrest (CA) and acute respiratory distress syndrome. ECMO is gradually showing its advantages in terms of speed and effectiveness of circulatory support, as it provides adequate cerebral blood flow (CBF) to the patient and ensures the perfusion of organs. ECMO enhances patient survival and improves their neurological prognosis. However, ECMO-related brain complications are also important because of the high risk of death and the associated poor outcomes. We summarized the reported complications related to ECMO for patients with CA, such as north-south syndrome, hypoxic-ischemic brain injury, cerebral ischemia-reperfusion injury, impaired intracranial vascular autoregulation, embolic stroke, intracranial hemorrhage, and brain death. The exact mechanism of ECMO on the role of brain function is unclear. Here we review the pathophysiological mechanisms associated with ECMO in the protection of neurologic function in recent years, as well as the ECMO-related complications in brain and the means to improve it, to provide ideas for the treatment of brain function protection in CA patients.
体外膜肺氧合（ECMO）在心脏骤停（CA）和急性呼吸窘迫综合征等危重症患者的治疗中发挥着重要作用。ECMO在循环支持的速度和有效性方面逐渐展现出优势，因为它能为患者提供充足的脑血流量（CBF）并确保器官灌注。ECMO提高了患者的生存率并改善了他们的神经预后。然而，由于死亡风险高及相关不良后果，ECMO相关的脑部并发症也很重要。我们总结了已报道的CA患者与ECMO相关的并发症，如南北综合征、缺氧缺血性脑损伤、脑缺血再灌注损伤、颅内血管自动调节受损、栓塞性中风、颅内出血和脑死亡。ECMO对脑功能作用的确切机制尚不清楚。在此，我们综述近年来与ECMO保护神经功能相关的病理生理机制，以及ECMO相关的脑部并发症及其改善方法，为CA患者脑功能保护的治疗提供思路。
