Burša Filip, Frelich Michal, Sklienka Peter, Jor Ondřej, Máca Jan
Department of Anaesthesiology, Resuscitation and Intensive Care Medicine, University Hospital Ostrava and Faculty of Medicine, University of Ostrava, 17. Listopadu 1790, 708 00 Ostrava, Czech Republic.
Institute of Physiology and Pathophysiology, Faculty of Medicine, University of Ostrava, Syllabova 19, 703 00 Ostrava, Czech Republic.
J Clin Med. 2023 Aug 9;12(16):5196. doi: 10.3390/jcm12165196.
Although extracorporeal life support is an expensive method with serious risks of complications, it is nowadays a well-established and generally accepted method of organ support. In patients with severe respiratory failure, when conventional mechanical ventilation cannot ensure adequate blood gas exchange, veno-venous extracorporeal membrane oxygenation (ECMO) is the method of choice. An improvement in oxygenation or normalization of acid-base balance by itself does not necessarily mean an improvement in the outcome but allows us to prevent potential negative effects of mechanical ventilation, which can be considered a crucial part of complex care leading potentially to an improvement in the outcome. The disconnection from ECMO or discharge from the intensive care unit should not be viewed as the main goal, and the long-term outcome of the ECMO-surviving patients should also be considered. Approximately three-quarters of patients survive the veno-venous ECMO, but various (both physical and psychological) health problems may persist. Despite these, a large proportion of these patients are eventually able to return to everyday life with relatively little limitation of respiratory function. In this review, we summarize the available knowledge on long-term mortality and quality of life of ECMO patients with respiratory failure.
尽管体外生命支持是一种昂贵且有严重并发症风险的方法，但如今它是一种成熟且普遍被接受的器官支持方法。在严重呼吸衰竭患者中，当传统机械通气无法确保充分的血气交换时，静脉 - 静脉体外膜肺氧合（ECMO）是首选方法。氧合改善或酸碱平衡正常化本身并不一定意味着预后改善，但能使我们预防机械通气的潜在负面影响，这可被视为复杂护理的关键部分，可能有助于改善预后。脱离ECMO或从重症监护病房出院不应被视为主要目标，还应考虑ECMO存活患者的长期预后。约四分之三的患者在静脉 - 静脉ECMO治疗后存活，但各种（身体和心理方面的）健康问题可能持续存在。尽管如此，这些患者中的很大一部分最终能够回归日常生活，呼吸功能受限相对较小。在本综述中，我们总结了关于呼吸衰竭ECMO患者长期死亡率和生活质量的现有知识。
