肺移植期间的内科外体支持:不仅适用于高风险患者
Daniel Laskey1, Brian Housman1, Gbalekan Dawodu1
1Thoracic Surgery Department, Icahn School of Medicine at Mount Sinai, Mount Sinai Health System, One Gustave L. Levy Place, Box 1023, New York, NY 10029, USA.
Journal of clinical medicine
|January 11, 2024
概括
在肺移植过程中,常规的手术内体外膜氧化 (ECMO) 改善了结果,并减少了并发症,与心肺绕道 (CPB) 或非方法相比. ECMO是一种安全有效的方法,建议将其视为更好的生存标准协议.
科学领域:
- 心血管外科心血管外科
- 移植医学 移植医学
- 呼吸系统医学 呼吸系统医学
背景情况:
- 肺移植的手术内机械支持已经发展,历史上依赖心肺旁路 (CPB).
- CPB提供血液动力学支持,但具有炎症,凝血病和增加出血等风险.
- 脱技术出现了,但体外膜氧化 (ECMO) 提供了一个潜在的优越替代方案.
研究的目的:
- 在肺移植中评估手术内机械支持策略的有效性和安全性.
- 为了比较与体外膜氧化 (ECMO) 与心肺旁路 (CPB) 和离移植相关的结果.
- 评估ECMO在缓解初级移植功能障碍和改善患者存活率方面的作用.
主要方法:
- 肺移植期间手术内机械支技术的比较分析.
- 对结果的审查,比较ECMO,CPB和外程序的数据.
- 评估移植保护,缺血-再输血损伤和呼吸器设置.
主要成果:
- 与CPB相比,ECMO的使用与较低的初级移植功能障碍率,减少输血需求和减少术后并发症有关.
- 接受ECMO支持的患者经历的损伤较少,ICU停留时间较短,住院死亡率较低.
- 计划内科ECMO证明了比计划外科ECMO和非移植更好的生存和结果.
结论:
- 术内ECMO是一种安全有效的肺移植策略,与CPB和非方法相比,它具有显著的优势.
- 规划的手术内ECMO的常规使用应被视为标准协议,以提高移植保护和患者的结果.
- ECMO促进肺保护性通风,减少关键不良事件,改善整体肺移植成功率.
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