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自体造血干细胞移植后伴全血细胞减少的脉-动脉体外膜肺氧合:美国心脏病学会患者护理途径。

Venoarterial Extracorporeal Membrane Oxygenation After Autologous Stem Cell Transplantation With Pancytopenia: JACC Patient Care Pathways.

机构信息

Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA.

Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.

出版信息

J Am Coll Cardiol. 2023 Jul 25;82(4):374-378. doi: 10.1016/j.jacc.2023.04.038. Epub 2023 Jun 6.

Abstract

Venoarterial extracorporeal membrane oxygenation (VA-ECMO) provides temporary mechanical circulatory support and simultaneous extracorporeal gas exchange for acute cardiorespiratory failure. By providing circulatory support, VA-ECMO gives treatments time to reach optimal efficacy or may be used as a bridge to a more durable mechanical solution for patients with acute cardiopulmonary failure. It is commonly used when a readily reversible etiology of decompensation is identified with very strict inclusion criteria for extracorporeal cardiopulmonary resuscitation use. We present a unique case in which VA-ECMO/extracorporeal cardiopulmonary resuscitation was used after cardiac arrest with pulseless electrical activity in a patient with recurrent lymphoma of the left thigh with recent autologous stem cell transplant.

摘要

静脉-动脉体外膜肺氧合(VA-ECMO)为急性心肺衰竭患者提供临时机械循环支持和体外气体交换。通过提供循环支持,VA-ECMO 为治疗争取了达到最佳疗效的时间,或者可以作为急性心肺衰竭患者更持久的机械解决方案的桥梁。当明确识别出有一个可迅速纠正的代偿失调病因,并且对外科心肺复苏的使用有非常严格的纳入标准时,通常会使用 VA-ECMO。我们报告了一例独特的病例,一名左大腿复发性淋巴瘤患者在最近接受自体干细胞移植后发生心搏骤停伴无脉性电活动,使用了 VA-ECMO/体外心肺复苏。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1d18/10894682/2daa76bb90a1/nihms-1961316-f0001.jpg

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