静脉外体膜氧化过程中的氧化:生理学,当前证据,以及对氧气定位的实用方法
Lavienraj Premraj1,2,3,4,5,6,7,8,9,10,11, Alastair Brown1,2,3,4,5,6,7,8,9,10,11, John F Fraser2
1Griffith University School of Medicine and Dentistry, Brisbane, QLD, Australia.
Critical care medicine
|December 7, 2023
概括
过氧症在静脉外体膜氧化 (ECMO) 患者中很常见,并且与更糟糕的结果有关. 本综述概述了导致高氧化症的因素,并提出了氧气定位策略,以改善患者的结果.
科学领域:
- 关键护理医学 关键护理医学
- 心血管外科心血管外科
- 呼吸系统生理学 呼吸系统生理学
背景情况:
- 外周静脉外体膜氧化 (VA-ECMO) 涉及人造电路与患者本体心肺呼吸系统之间的复杂相互作用.
- 在VA-ECMO期间的系统氧化受ECMO电路参数 (例如血流) 和原生生理因素 (例如心脏输出,呼吸功能) 的影响.
- 接受VA-ECMO治疗的患者在生理上容易出现高氧症,PaO2>150 mmHg,严重的高氧症 (>300 mmHg) 发生在20%的患者中.
结论:
- 周围VA-ECMO期间的高氧症是由各种电路和患者特异性因素引起的.
- 在VA-ECMO患者中,高氧的存在与不良的临床结果相关.
- 在VA-ECMO中,氧气管理的实际策略包括准特定的氧和水平,并调整吸入氧气以防止高氧和低氧.
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