Hall James, Khilkin Michael, Murphy Sara, Botros George
Grossman School of Medicine, New York University Langone, New York, NY 10016, USA.
Columbia University Medical Center, New York, NY 10032, USA.
Reports (MDPI). 2023 Mar 20;6(1):17. doi: 10.3390/reports6010017.
Extracorporeal membrane oxygenation (ECMO) can be a life-saving intervention in cases of potentially reversible refractory respiratory failure. One such indication can be bleomycin-induced lung injury. However, in some cases, the injury can be so severe that it becomes irreversible and creates complex medical decisions regarding life support and the continuation of care when no additional therapeutic options are feasible, particularly in cases of patients who were young and fully functional prior to an acute illness. In cases of full pulmonary replacement with mechanical support and the degree of functionality that can be attained utilizing modalities such as ECMO can obscure the true severity of illness and make end-of-life decisions significantly harder for families and caregivers.
体外膜肺氧合（ECMO）对于潜在可逆性难治性呼吸衰竭病例可能是一种挽救生命的干预措施。其中一种适应症可能是博来霉素诱导的肺损伤。然而，在某些情况下，损伤可能非常严重，以至于变得不可逆转，并在没有其他可行治疗选择时，就生命支持和继续护理产生复杂的医疗决策，特别是对于那些在急性疾病发作前年轻且功能完全正常的患者。在通过机械支持进行全肺替代以及利用ECMO等方式所能达到的功能程度的情况下，可能会掩盖疾病的真正严重程度，使家庭和护理人员做出临终决策变得更加困难。
