Kruse J-M, Nee J, Eckardt K-U, Wengenmayer T
Medizinische Klinik mit Schwerpunkt Nephrologie und internistische Intensivmedizin, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Deutschland.
Interdisziplinäre Medizinische Intensivtherapie (IMT), Universitätsklinikum Freiburg, Medizinische Fakultät, Universität Freiburg, Freiburg, Deutschland.
Med Klin Intensivmed Notfmed. 2024 Jun;119(5):346-351. doi: 10.1007/s00063-024-01131-1. Epub 2024 Apr 3.
The use of extracorporeal circulatory support, both for cardiogenic shock and during resuscitation, still presents many unanswered questions. The inclusion and exclusion criteria for such a resource-intensive treatment must be clearly defined, considering that these criteria are directly associated with the type and location of treatment. For example, it is worth questioning the viability of an extracorporeal resuscitation program in areas where it is impossible to achieve low-flow times under 60 min due to local limitations. Additionally, the best approach for further treatment, including whether it is necessary to regularly relieve the left ventricle, must be explored. To find answers to some of these questions, large-scale, multicenter, randomized studies and registers must be performed. Until then this treatment must be carefully considered before use.
体外循环支持在治疗心源性休克及复苏过程中的应用仍存在诸多未解决的问题。鉴于这些标准与治疗类型和地点直接相关,必须明确这种资源密集型治疗的纳入和排除标准。例如,在因当地条件限制无法将低流量时间控制在60分钟以内的地区,质疑体外复苏方案的可行性是有必要的。此外,必须探索进一步治疗的最佳方法,包括是否有必要定期减轻左心室负担。为了找到其中一些问题的答案,必须开展大规模、多中心、随机研究和登记工作。在此之前,使用这种治疗方法必须谨慎考虑。