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外体膜氧化用于心脏骤停:什么,何时,为什么,以及如何

Matthew Brandorff¹, Clark G Owyang^1,2, Joseph E Tonna^3,4

¹Division of Pulmonary and Critical Care Medicine, Department of Medicine, NewYork-Presbyterian Hospital/Weill Cornell Medical College, New York, NY, USA.

Expert review of respiratory medicine

|November 27, 2023

概括

身体外心肺复苏 (ECPR) 在专业系统中的精选患者中,可改善耐心性心脏骤停的生存率. 仔细实施和进一步研究对于优化结果至关重要.

科学领域:

心脏病学心脏病学
临界护理医学临界护理医学
紧急医疗紧急医疗

背景情况:

自20世纪60年代以来,体外膜氧化 (ECMO) 促进的复苏已经发生了显著的进化.
最近的大型观测研究和随机试验越来越关注它的应用.

研究的目的:

提供对体外心肺复苏 (ECPR) 的全面审查.
涵盖ECPR的历史,术语,电路配置,通道,并发症,选择标准和管理.
讨论结果并倡导注册表参与以提高质量.

主要方法:

历史数据和最近的大型观测研究的审查.
对评估ECPR的随机试验的分析.
综合ECPR实施和管理的当前指南和最佳实践.

主要成果:

在高度精选的患者和系统中,ECPR可以在耐心性心脏骤停中增加高达30%的存活率.
高生存率取决于紧密的协议设置和高体积的环境.
最近的试验表明,在控制较少的环境中实施时,有效性降低.

结论:

在心脏骤停复苏方面,ECPR代表了破坏性的进步.
最佳启动值,实施最佳实践和复苏后护理需要进一步研究.
参与国家/国际注册表对于ECPR的持续质量改进和科学发现至关重要.

关键词:

身体外心肺复苏术心脏骤停是因为心脏停止了.身体外生命支持身体外膜氧化氧化复苏是复苏的方法之一.

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