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[低容量周边医院中的体外膜肺氧合治疗]

[ECMO therapies in a low-volume, peripheral hospital].

作者信息

Hoechter Dominik J, Oss Bernhard, Schmölz Martin, Scheiermann Patrick

机构信息

Klinik für Anaesthesiologie, LMU-Klinikum, Ludwig-Maximilians-Universität München, Marchioninistr. 15, 81377, München, Deutschland.

Klinik für Anästhesie, Intensiv- und Notfallmedizin, Klinik Immenstadt, Klinikverbund Allgäu gGmbH, Immenstadt, Deutschland.

出版信息

Med Klin Intensivmed Notfmed. 2025 May 23. doi: 10.1007/s00063-025-01288-3.

Abstract

INTRODUCTION

Extracorporeal membrane oxygenation (ECMO) is a therapeutic option for otherwise refractory pulmonary or cardiac failure. While ECMO therapy, as a highly invasive and high-risk procedure, is primarily offered at specialized centers, the time between the indication for and the implementation of ECMO therapy is outcome-relevant. This raises the question of whether ECMO therapy can be safely and successfully implemented in peripheral hospitals.

METHODS

This retrospective analysis comprised all ECMO patients of a regional hospital for the period 2013-2023. Demographic data as well as therapy and survival data were recorded.

RESULTS

During the 10-year observation period, 54 ECMO treatments were performed at the center (53 venovenous ECMO, 1 venoarterial ECMO), of which four were transferred to a specialized center after the therapy was initiated. Of the remaining 50 patients, 24 survived the intensive care therapy (48%).

CONCLUSION

The present study demonstrates that ECMO therapies can be performed safely and with similar outcomes at peripheral hospitals, particularly if supported by a collaborating specialized center. Thus, transfers to specialized centers can be limited to patients with complicated courses.

摘要

引言

体外膜肺氧合(ECMO)是治疗难治性肺衰竭或心力衰竭的一种选择。虽然ECMO治疗作为一种高侵入性和高风险的程序,主要在专业中心进行,但从ECMO治疗指征出现到实施治疗的时间与治疗结果相关。这就提出了一个问题,即ECMO治疗能否在外围医院安全、成功地实施。

方法

这项回顾性分析纳入了一家地区医院2013年至2023年期间所有接受ECMO治疗的患者。记录了人口统计学数据以及治疗和生存数据。

结果

在10年的观察期内,该中心共进行了54次ECMO治疗(53次静脉-静脉ECMO,1次静脉-动脉ECMO),其中4例在治疗开始后转至专业中心。其余50例患者中,24例在重症监护治疗后存活(48%)。

结论

本研究表明,在外围医院可以安全地进行ECMO治疗,且治疗结果相似,特别是在有合作专业中心支持的情况下。因此,转至专业中心的情况可以仅限于病程复杂的患者。

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