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静脉-肺体外膜肺氧合用于右心室支持作为肺移植的桥梁:一项叙述性综述。

Venopulmonary extracorporeal membrane oxygenation for right ventricular support as a bridge to lung transplantation: A narrative review.

作者信息

Thuan Phan Quang, Nam Nguyen Hoai, Dinh Nguyen Hoang

机构信息

Department of Cardiovascular Surgery, University Medical Center HCMC, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam.

Department of Cardiovascular and Thoracic Surgery, Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Vietnam.

出版信息

SAGE Open Med. 2024 Oct 16;12:20503121241275410. doi: 10.1177/20503121241275410. eCollection 2024.

DOI:10.1177/20503121241275410
PMID:39483623
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11526258/
Abstract

This review evaluates the effectiveness of veno-pulmonary support with an oxygenator using extracorporeal membrane oxygenation as a bridge to lung transplantation strategy in patients undergoing veno-venous extracorporeal membrane oxygenation while awaiting lung transplantation. Examining indications, contraindications, and clinical outcomes, the study highlights potential benefits, drawing insights from successful cases in South Korea and the United States. Despite limited sample sizes, veno-pulmonary support with an oxygenator using extracorporeal membrane oxygenation emerges as a promising approach for further investigation in lung transplantation support. The review emphasizes its role in improving hemodynamic status, preventing complications during extended waiting periods, and presenting a cost-effective alternative to traditional methods, especially in developing countries. While in-hospital mortality rates range from 0% to 10%, comparable to other approaches, cautious optimism surrounds veno-pulmonary support with an oxygenator using extracorporeal membrane oxygenation, urging expanded research to solidify its standing in enhancing patient outcomes, reducing costs, and promoting transplant success.

摘要

本综述评估了在等待肺移植期间接受静脉-静脉体外膜肺氧合的患者中,使用体外膜肺氧合氧合器进行静脉-肺支持作为肺移植过渡策略的有效性。通过研究适应症、禁忌症和临床结果,该研究突出了潜在益处,并借鉴了韩国和美国的成功案例。尽管样本量有限,但使用体外膜肺氧合氧合器进行静脉-肺支持仍是肺移植支持领域值得进一步研究的有前景的方法。该综述强调了其在改善血流动力学状态、预防延长等待期并发症方面的作用,并且作为传统方法的一种经济有效的替代方案,尤其在发展中国家。虽然住院死亡率在0%至10%之间,与其他方法相当,但对于使用体外膜肺氧合氧合器进行静脉-肺支持仍需谨慎乐观,需要扩大研究以巩固其在改善患者预后、降低成本和促进移植成功方面的地位。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c77/11526258/c4dcaaeabb62/10.1177_20503121241275410-fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c77/11526258/e268ebcafced/10.1177_20503121241275410-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c77/11526258/c4dcaaeabb62/10.1177_20503121241275410-fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c77/11526258/e268ebcafced/10.1177_20503121241275410-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c77/11526258/c4dcaaeabb62/10.1177_20503121241275410-fig2.jpg

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本文引用的文献

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J Heart Lung Transplant. 2024 Aug;43(8):1358-1366. doi: 10.1016/j.healun.2024.01.014. Epub 2024 Feb 2.
2
Standardized nomenclature for peripheral percutaneous cannulation of the pulmonary artery in extracorporeal membrane oxygenation: Current uptake and recommendations for improvement.体外膜肺氧合中经外周穿刺肺动脉置管的标准化命名:当前应用情况及改进建议。
Perfusion. 2024 Nov;39(8):1538-1544. doi: 10.1177/02676591231210457. Epub 2023 Nov 6.
3
Extracorporeal life support as a bridge to lung transplantation: a narrative review.
体外生命支持作为肺移植的桥梁:一项叙述性综述
J Thorac Dis. 2023 Sep 28;15(9):5221-5231. doi: 10.21037/jtd-22-1163. Epub 2023 Jul 28.
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Pulmonary hypertension associated with lung disease: new insights into pathomechanisms, diagnosis, and management.肺部疾病相关肺动脉高压:病理机制、诊断和治疗新见解。
Lancet Respir Med. 2023 Sep;11(9):820-835. doi: 10.1016/S2213-2600(23)00259-X. Epub 2023 Aug 14.
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Right ventricular dysfunction in patients with acute respiratory distress syndrome receiving venovenous extracorporeal membrane oxygenation.接受静脉-静脉体外膜肺氧合治疗的急性呼吸窘迫综合征患者的右心室功能障碍
Front Cardiovasc Med. 2023 May 17;10:1027300. doi: 10.3389/fcvm.2023.1027300. eCollection 2023.
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Technical considerations for percutaneous pulmonary artery cannulation for mechanical circulatory support.用于机械循环支持的经皮肺动脉插管的技术考量
JTCVS Tech. 2022 Dec 23;18:65-73. doi: 10.1016/j.xjtc.2022.11.017. eCollection 2023 Apr.
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