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全血细胞减少症自体干细胞移植后静脉-动脉体外膜肺氧合:患者护理路径

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

作者信息

Howick V James F, Rezkalla Joshua A, Tilbury Thomas, Mankad Sunil V, Bennett Courtney E, Herrmann Joerg, Barsness Gregory, Ansell Stephen M, Read Matthew D

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

JACC Case Rep. 2023 Jun 6;18:101913. doi: 10.1016/j.jaccas.2023.101913. eCollection 2023 Jul 19.

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)为急性心肺衰竭提供临时的机械循环支持和同步的体外气体交换。通过提供循环支持,VA-ECMO为治疗争取时间以达到最佳疗效,或可作为急性心肺衰竭患者通向更持久机械解决方案的桥梁。当确定存在易于逆转的失代偿病因且符合体外心肺复苏使用的非常严格的纳入标准时,VA-ECMO通常会被采用。我们报告了一例独特病例,一名近期接受自体干细胞移植的左大腿复发性淋巴瘤患者发生心脏骤停且出现无脉电活动后,使用了VA-ECMO/体外心肺复苏。

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