Altose M D, Hicks R E, Edwards M W
Arch Surg. 1976 Oct;111(10):1149-53. doi: 10.1001/archsurg.1976.01360280106017.
Extracorporeal membrane oxygenation (ECMO) in a venoarterial perfusion circuit was used to provide support of gas exchange during bronchopulmonary lavage in a 32-year-old man with pulmonary alveolar proteinosis and severe arterial hypoxemia. Prior to the lavage, Pao2 during mechanical ventilation with 100% oxygen and positive end-expiratory pressure was only 125 mm Hg. Extracorporeal perfusion at a flow rate of 3 liters/min, with oxygen delivery of 244 ml/min, increased the Pao2 to 227 mmHg and lowered the mean pulmonary artery pressure from 28 to 24 mm Hg. During bronchopulmonary lavage and ECMO, the Pao2 ranged between 46 and 96 mm Hg. After the procedure, pulmonary performance decidely improved. By reducing the chances of fatal hypoxemia, ECMO allowed treatment to be instituted for this potentially reversible disorder and proved helpful as a form of support during the management of pulmonary alveolar proteinosis when severe hypoxemia may have other wise precluded bronchopulmonary lavage.
在一名患有肺泡蛋白沉积症和严重动脉低氧血症的32岁男性患者进行支气管肺灌洗期间，采用静脉 - 动脉灌注回路的体外膜肺氧合（ECMO）来支持气体交换。在灌洗前，使用100%氧气和呼气末正压进行机械通气时，动脉血氧分压（Pao2）仅为125 mmHg。以3升/分钟的流速进行体外灌注，氧输送量为244毫升/分钟，将Pao2提高到227 mmHg，并使平均肺动脉压从28 mmHg降至24 mmHg。在支气管肺灌洗和ECMO期间，Pao2在46至96 mmHg之间波动。手术后，肺部功能明显改善。通过减少致命性低氧血症的发生几率，ECMO使得针对这种潜在可逆性疾病的治疗得以开展，并且在肺泡蛋白沉积症的治疗过程中，当严重低氧血症可能否则会妨碍支气管肺灌洗时，ECMO作为一种支持形式被证明是有帮助的。
