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[体外膜肺氧合治疗成人呼吸窘迫综合征。2例患者的经验]

[Extracorporeal membrane oxygenation in adult respiratory distress syndrome. Experience in 2 patients].

作者信息

Alamo M, Castro J, Alvarez E, Brunet L

机构信息

Departamento de Anestesia y Reanimación, Universidad de Chile, Santiago.

出版信息

Rev Med Chil. 1995 Oct;123(10):1275-83.

PMID:8733320
Abstract

We report two female patients with adult respiratory distress syndrome and severe respiratory failure in whom extracorporeal membrane oxygenation was used. Its indication was due to a bad response to conventional treatment with mechanical ventilation and high levels of positive end expiratory pressure. A 2.0 or 2.2 m2 membrane oxygenator in a veno-venous circuit with systemic anticoagulation was used, maintaining mechanical ventilation. In the first patient, the procedure was done early and was successful, increasing hemoglobin saturation from 39 to 87%. The patient was withdrawn from the procedure 48 hours later and died one week later due to a septic shock. The second patient was connected to the procedure after three weeks of respiratory distress syndrome and no increase in arterial oxygenation was achieved. The patient died due to an intracranial hemorrhage, probably hastened by systemic anticoagulation. The real benefits of extracorporeal membrane oxygenation are not defined yet.

摘要

我们报告了两名患有成人呼吸窘迫综合征和严重呼吸衰竭并接受体外膜肺氧合治疗的女性患者。其适应症是对机械通气和高水平呼气末正压的传统治疗反应不佳。使用了一个2.0或2.2平方米的膜式氧合器,采用静脉-静脉回路并进行全身抗凝,同时维持机械通气。在第一名患者中,该操作进行得较早且成功,血红蛋白饱和度从39%提高到了87%。48小时后该患者停止了该治疗,一周后因感染性休克死亡。第二名患者在呼吸窘迫综合征三周后接受该治疗,动脉氧合未增加。该患者死于颅内出血,可能是全身抗凝加速了死亡。体外膜肺氧合的真正益处尚未明确。

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