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中华肺部疾病杂志(电子版) ›› 2023, Vol. 16 ›› Issue (06) : 899 -902. doi: 10.3877/cma.j.issn.1674-6902.2023.06.038

综述

ECMO在成人呼吸衰竭治疗及转运中的应用进展
奚琼, 芮祖琴()   
  1. 430072 武汉,武汉大学护理学院;241000 芜湖,安徽省皖南康复医院(芜湖市第五人民医院)
    430072 武汉,武汉大学护理学院
  • 收稿日期:2023-09-19 出版日期:2023-12-25
  • 通信作者: 芮祖琴

Application of ECMO in the treatment and transport of adult respiratory failure

Qiong Xi, Zuqin Rui()   

  • Received:2023-09-19 Published:2023-12-25
  • Corresponding author: Zuqin Rui
引用本文:

奚琼, 芮祖琴. ECMO在成人呼吸衰竭治疗及转运中的应用进展[J]. 中华肺部疾病杂志(电子版), 2023, 16(06): 899-902.

Qiong Xi, Zuqin Rui. Application of ECMO in the treatment and transport of adult respiratory failure[J]. Chinese Journal of Lung Diseases(Electronic Edition), 2023, 16(06): 899-902.

体外膜氧合(extracorporeal membrane oxygenation, ECMO)可用于难治性严重呼吸衰竭或心力衰竭的抢救。呼吸衰竭是多种原因引起的肺通气和/或换气功能严重障碍,不能进行有效气体交换,导致缺氧伴或不伴二氧化碳潴留,引起一系列生理功能和代谢紊乱的临床综合征[1,2]。严重急性呼吸衰竭病死率高[3]。1972年ECMO用于成人呼吸衰竭治疗,30多年来ECMO使用报道尚少,少数应用不理想[4,5,6,7]。近年来,随着ECMO技术的发展,临床应用不断增加,越来越多数据开始支持ECMO在成人呼吸衰竭救治中的应用价值。

1
邵秋萍. 面罩机械通气治疗急性呼吸衰竭12例疗效观察[J]. 江苏大学学报(医学版), 2004, 14(4): 59-60.
2
张秀敏,武海燕,孙晓娟. 无创呼吸机对AECOPD合并呼吸衰竭患者炎性因子及呼吸功能的影响[J]. 宁夏医科大学学报2016, 38(9): 1071-1074.
3
陈 林,谭小武,丁罗生,等. 无创正压通气治疗重症免疫抑制相关性肺病28例[J]. 中南医学科学杂志2011, 39(5): 538-540.
4
Hill JD, O′Brien TG, Murray JJ, et al. Prolonged extracorporeal oxygenation for acute post-traumatic respiratory failure (shock-lung syndrome). Use of the Bramson membrane lung[J]. N Engl J Med, 1972, 286(12): 629-634.
5
梅喜平,袁利学,祝小梅,等. 体外膜肺氧合在危重症患者中的临床应用[J/CD]. 中华肺部疾病杂志(电子版), 2022, 15(2): 206-208.
6
敬颖洁,刘 畅,李福祥. 体外膜肺氧合在急性呼吸窘迫综合征中的应用进展[J/CD]. 中华肺部疾病杂志(电子版), 2015, 8(4): 478-481.
7
Paden ML, Conrad SA, Rycus PT, et al. Extracorporeal life support organization registry report 2012[J]. ASAIO J, 2013, 59(3): 202-210.
8
Gattinoni L, Pesenti A. The concept of " baby lung" [J]. Intensive Care Med, 2005, 31(6): 776-784.
9
邱 维,陈应富,刘成军. 体外膜肺氧合在儿科重症监护病房的应用与管理[J]. 儿科药学杂志2023, 29(04): 50-55.
10
Zapol WM, Snider MT, Hill JD, et al. Extracorporeal membrane oxygenation in severe acute respiratory failure. A randomized prospective study[J]. JAMA, 1979, 242(20): 2193-2196.
11
Gattinoni L, Pesenti A, Mascheroni D, et al. Low-frequency positive-pressure ventilation with extracorporeal CO2 removal in severe acute respiratory failure[J]. JAMA, 1986, 256(7): 881-886.
12
Morris AH, Wallace CJ, Menlove RL, et al. Randomized clinical trial of pressure-controlled inverse ratio ventilation and extracorporeal CO2 removal for adult respiratory distress syndrome[J]. Am J Respir Crit Care Med, 1994, 149(2 Pt 1): 295-305.
13
Kolla S, Awad SS, Rich PB, et al. Extracorporeal life support for 100 adult patients with severe respiratory failure[J]. Ann Surg, 1997, 226(4): 544-564; discussion 565-546.
14
Linden V, Palmer K, Reinhard J, et al. High survival in adult patients with acute respiratory distress syndrome treated by extracorporeal membrane oxygenation, minimal sedation, and pressure supported ventilation[J]. Intensive Care Med, 2000, 26(11): 1630-1637.
15
Peek GJ, Mugford M, Tiruvoipati R, et al. Efficacy and economic assessment of conventional ventilatory support versus extracorporeal membrane oxygenation for severe adult respiratory failure (CESAR): a multicentre randomised controlled trial [J]. Lancet, 2009, 374(9698): 1351-1363.
16
Ma X, Liang M, Ding M, et al. Extracorporeal membrane oxygenation (ECMO) in critically Ⅲ patients with coronavirus disease 2019 (COVID-19) pneumonia and acute respiratory distress syndrome (ARDS)[J]. Med Sci Monit, 2020, 26: e925364.
17
YEO HJ, SON J, LEE SG, et al. Clinical result and feasibility of transport ECMO in thoracic transplantation[J]. Transplant Proc, 2019, 51(10): 3385-3390.
18
AL-Fares A, Pettenuzzo T, Del Sorbo L. Extracorporeal life support and systemic inflammation[J]. Intensive Care Med Exp, 2019, 7(Suppl 1): 46.
19
Datzmann T, Trager K. Extracorporeal membrane oxygenation and cytokine adsorption[J]. J Thorac Dis, 2018, 10(Suppl 5): S653-S660.
20
Millar JE, Fanning JP, Mcdonald CI, et al. The inflammatory response to extracorporeal membrane oxygenation (ECMO): a review of the pathophysiology[J]. Crit Care, 2016, 20(1): 387.
21
Ratnani I, Tuzzon D, Zainab A, et al. The role and impact of extracorporeal membrane oxygenation in critical care[J]. Methodist Debakey Cardiovasc J, 2018, 14(2): 110-119.
22
Jooste R, Rowan KM, Symes N, et al. Scaling up a national extracorporeal membrane oxygenation referral service for adult patients in acute severe respiratory failure at the time of a pandemic[J]. J Intensive Care Soc, 2022, 23(4): 473-478.
23
Jayaraman AL, Cormican D, Shah P, et al. Cannulation strategies in adult veno-arterial and veno-venous extracorporeal membrane oxygenation: Techniques, limitations, and special considerations[J]. Ann Card Anaesth, 2017, 20(Supplement): S11-S18.
24
Mazzeffi M, Galvagno S, Menaker J. VV ECMO Cannulation: Should I Stay or Should I Go? [J]. J Cardiothorac Vasc Anesth, 2019, 33(7): 1871-1872.
25
Kimmoun A, Roche S, Bridey C, et al. Prolonged prone positioning under VV-ECMO is safe and improves oxygenation and respiratory compliance[J]. Ann Intensive Care, 2015, 5(1): 35.
26
Li Y, Yan S, Cai L, et al. Does VA-ECMO plus impella work in refractory cardiogenic shock?[J]. JACC Heart Fail, 2019, 7(4): 364.
27
Wang L, Yang F, Wang X, et al. Predicting mortality in patients undergoing VA-ECMO after coronary artery bypass grafting: the REMEMBER score[J]. Crit Care, 2019, 23(1): 11.
28
唐绪荣,聂 谦,赵 珏,等. 体外膜肺氧合联合主动脉内球囊反搏治疗急性心肌梗死合并心源性休克1例[J]. 中南医学科学杂志2020, 48(03): 333-336.
29
Force ADT, Ranieri VM, Rubenfeld GD, et al. Acute respiratory distress syndrome: the Berlin Definition[J]. JAMA, 2012, 307(23): 2526-2533.
30
李全正,阮昕华,杨志祥. 体外膜氧合在新型冠状病毒肺炎患者中的应用[J]. 中国体外循环杂志2021, 19(5): 308-310.
31
Combes A, Hajage D, Capellier G, et al. Extracorporeal membrane oxygenation for severe acute respiratory distress syndrome[J]. N Engl J Med, 2018, 378(21): 1965-1975.
32
Australia and New Zealand Extracorporeal Membrane Oxygenation (ANZ ECMO) Influenza Investigators; Davies Andrew, Jones Daryl, Bailey Michael, et al. Extracorporeal Membrane Oxygenation for 2009 Influenza A(H1N1) Acute Respiratory Distress Syndrome[J]. JAMA, 2009, 302(17): 1888-1895.
33
Zangrillo Alberto, Biondi-Zoccai Giuseppe, Landoni Giovanni, et al. Extracorporeal membrane oxygenation (ECMO) in patients with H1N1 influenza infection: a systematic review and meta-analysis including 8 studies and 266 patients receiving ECMO[J]. Crit Care, 2013, 17(1): R30.
34
Sukhal Shashvat, Sethi Jaskaran, Ganesh Malini, et al. Extracorporeal membrane oxygenation in severe influenza infection with respiratory failure: A systematic review and meta-analysis[J]. Ann Card Anaesth, 2017, 20(1): 14-21.
35
Noah Moronke A, Peek Giles J, Finney Simon J, et al. Referral to an extracorporeal membrane oxygenation center and mortality among patients with severe 2009 influenza A(H1N1)[J]. JAMA, 2011, 306(15): 1659-1668.
36
Al-Dorzi Hasan M, Aldawood Abdulaziz S, Raymond Khan, et al. The critical care response to a hospital outbreak of Middle East respiratory syndrome coronavirus (MERS-CoV) infection: an observational study[J]. Ann Intensive Care, 2016, 6(1): 101.
37
Choi WS, Kang CI, Kim Y, et al. Clinical presentation and outcomes of middle east respiratory syndrome in the republic of Korea[J]. Infect Chemother, 2016, 48(2): 118-126.
38
Arabi Yaseen M, Al-Omari Awad, Mandourah Yasser, et al. Critically Ⅲ patients with the middle east respiratory syndrome: A multicenter retrospective cohort study[J]. Crit Care Med, 2017, 45(10): 1683-1695.
39
Shalhoub Sarah, Al-Hameed Fahad, Mandourah Yasser, et al. Critically ill healthcare workers with the middle east respiratory syndrome (MERS): A multicenter study[J]. Plos One, 2018, 13(11): e0206831.
40
Alshahrani Mohammed S, Sindi Anees, Alshamsi Fayez, et al. Extracorporeal membrane oxygenation for severe Middle East respiratory syndrome coronavirus[J]. Ann Intensive Care, 2018, 8(1): 3.
41
谢 丹,陈俊春,邱 婷,等. 重型新型冠状病毒肺炎118例临床特征分析 [J]. 江苏大学学报(医学版), 2021, 31(2): 139-142.
42
Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China[J]. Lancet, 2020, 395(10223): 497-506.
43
Wang D, Hu B, Hu C, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China[J]. JAMA, 2020, 323(11): 1061-1069.
44
Yang X, Yu Y, Xu J, et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study[J]. Lancet Respir Med, 2020, 8(5): 475-481.
45
Zeng Y, Cai Z, Xianyu Y, et al. Prognosis when using extracorporeal membrane oxygenation (ECMO) for critically ill COVID-19 patients in China: a retrospective case series[J]. Crit Care, 2020, 24(1): 148.
46
Chong WH, Saha BK, Medarov BI. A systematic review and meta-analysis comparing the clinical characteristics and outcomes of COVID-19 and influenza patients on ECMO[J]. Respir Investig, 2021, 59(6): 748-756.
47
Mattar A, Chatterjee S, Loor G. Bridging to lung transplantation [J]. Crit Care Clin, 2019, 35(1): 11-25.
48
Fuehner T, Kuehn C, Hadem J, et al. Extracorporeal membrane oxygenation in awake patients as bridge to lung transplantation [J]. Am J Respir Crit Care Med, 2012, 185(7): 763-768.
49
Javidfar Jeffrey, Bacchetta Matthew. Bridge to lung transplantation with extracorporeal membrane oxygenation support[J]. Curr Opin Organ Transplant, 2012, 17(5): 496-502.
50
Bryner Benjamin, Cooley Elaine, Copenhaver William, et al. Two decades′experience with interfacility transport on extracorporeal membrane oxygenation[J]. Ann Thorac Surg, 2014, 98(4): 1363-1370.
51
Labib Ahmed, August Erin, Agerstrand Cara, et al. Extracorporeal life support organization guideline for transport and retrieval of adult and pediatric patients with ECMO support[J]. ASAIO J, 2022, 68(4): 447-455.
52
金俊英. 运用ECMO支持重症新型冠状病毒肺炎患者的成功转运 [J]. 中国急救复苏与灾害医学杂志2022, 17(1): 6-7.
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