静脈 動脈 ECMO で の 左 心室 の 排気: だれ の 中 で,いつ,そして どの よう に する か
Saad M Ezad1, Matthew Ryan1, Dirk W Donker2
1British Heart Foundation Centre of Research Excellence and National Institute for Health and Care Research Biomedical Research Centre at the School of Cardiovascular and Metabolic Medicine and Sciences, King's College London, UK (S.M.E., M.R., D.P.).
Circulation
|April 17, 2023
まとめ
静脈外膜酸素化 (VA-ECMO) は左心室 (LV) の余剰負荷を悪化させる可能性があります. VA-ECMO中のLVの排出戦略は結果を改善するかもしれないが,最適な使用は不明である.
科学分野:
- 心臓病科
- 心血管外科
- クリティカル ケア 医療
背景:
- 静脈外膜酸素化 (VA-ECMO) は,心臓発作性ショックにおける重要な心臓呼吸器のサポートを提供します.
- しかし,VA- ECMOは,逆行性大動脈の流れによる左心房 (LV) の余分な負荷を増加させ,LVの膨張と肺腫のような合併症を引き起こす可能性があります.
結論:
- 観察データは,VA-ECMOでのLVの卸しで改善された結果を示唆しているが,明確なガイドラインは欠けている.
- 装置による合併症のリスクとのバランスを取ることが重要です.
- LVの卸し戦略の正確な役割と実施を明確にするためにさらなる研究が必要である.
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