Center for Critical Care, Houston Methodist, Houston, Texas, US.
Houston Methodist Cardiovascular Surgery Associates, Houston, Texas, US.
Methodist Debakey Cardiovasc J. 2023 Aug 1;19(4):66-73. doi: 10.14797/mdcvj.1256. eCollection 2023.
Postcardiotomy extracorporeal membrane oxygenation (PC-ECMO), the most frequent indication for ECMO in the United States, is increasingly used as the first-line mechanical circulatory support in patients who are refractory to conventional treatment. Despite increasing use of PC-ECMO, limited evidence is available regarding its safety, efficacy, and optimal timing for initiation and weaning. The decision to use PC-ECMO often is made in the absence of robust clinical data, leading to variability in patient selection, management, and outcomes across different institutions. This article summarizes current evidence on ECMO use in postcardiotomy cardiogenic shock and discusses its potential benefits, management, complications, and outcomes.
体外膜肺氧合（ECMO）在心外科术后的应用（PC-ECMO）是美国最常见的 ECMO 适应证，目前越来越多地被用于对常规治疗无效的患者的一线机械循环支持。尽管 PC-ECMO 的应用越来越广泛，但关于其安全性、疗效以及启动和脱机的最佳时机的证据有限。由于缺乏强有力的临床数据，因此在决定使用 PC-ECMO 时，往往会导致不同机构之间在患者选择、管理和结果方面存在差异。本文总结了 ECMO 在心脏手术后心源性休克中的应用的现有证据，并讨论了其潜在的益处、管理、并发症和结局。
