Elliott Andrea, Dahyia Garima, Kalra Rajat, Alexy Tamas, Bartos Jason, Kosmopoulos Marinos, Yannopoulos Demetri
Department of Medicine, Division of Cardiology, University of Minnesota Minneapolis, MN.
Department of Medicine, Division of Cardiology, Center for Resuscitation Medicine, University of Minnesota Minneapolis, MN.
US Cardiol. 2021 Nov 10;15:e23. doi: 10.15420/usc.2021.13. eCollection 2021.
The rising incidence and recognition of cardiogenic shock has led to an increase in the use of veno-arterial extracorporeal membrane oxygenation (VA-ECMO). As clinical experience with this therapy has increased, there has also been a rapid growth in the body of observational and randomized data describing the clinical and logistical considerations required to institute a VA-ECMO program with successful clinical outcomes. The aim of this review is to summarize this contemporary data in the context of four key themes that pertain to VA-ECMO programs: the principles of patient selection; basic hemodynamic and technical principles underlying VA-ECMO; contraindications to VA-ECMO therapy; and common complications and intensive care considerations that are encountered in the setting of VA-ECMO therapy.
心源性休克发病率的上升及其诊断率的提高，导致静脉-动脉体外膜肺氧合（VA-ECMO）的使用增加。随着这种治疗临床经验的积累，描述建立具有成功临床结果的VA-ECMO项目所需的临床和后勤考虑因素的观察性和随机数据也迅速增加。本综述的目的是在与VA-ECMO项目相关的四个关键主题背景下总结这些当代数据：患者选择原则；VA-ECMO的基本血流动力学和技术原理；VA-ECMO治疗的禁忌症；以及VA-ECMO治疗过程中常见的并发症和重症监护注意事项。
