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在LVAD植入后的患者中,成功支持ECMO治疗COVID-19引起的严重ARDS

Almas Begdildayev¹, Seitkhan Joshibayev¹, Baglan Turtabayev¹

¹Research and Clinical Center for Cardiac Surgery and Transplantology, Taraz, Kazakhstan.

Indian journal of thoracic and cardiovascular surgery

|February 23, 2024

概括

本案例报告详细介绍了COVID-19引起的急性呼吸困扰综合征 (ARDS) 和左心室辅助装置 (LVAD) 植入后右心室衰竭患者的修改体外膜氧化 (ECMO) 策略,导致完全康复.

科学领域:

心脏病学心脏病学
肺部病理学肺部病理学
关键护理医学关键护理医学

背景情况:

左心室辅助器件 (LVAD) 对等待移植的末期心力衰竭患者至关重要.
COVID-19可以导致严重的呼吸衰竭和急性呼吸困扰综合征 (ARDS),右心室 (RV) 衰竭的风险很大.
RV功能障碍是ARDS患者已知的并发症,对那些有先前存在的心脏支持的人来说是一个挑战.

研究的目的:

描述一种新的修改的体外膜氧化 (ECMO) 管策略.
在LVAD植入后患有ARDS的患者中支持右心室和肺部衰竭.
为了证明这种方法在实现患者康复方面的有效性.

主要方法:

在LVAD植入后6个月的COVID-19引起的ARDS和RV衰竭的22岁女性患者接受了治疗.
采用经过修改的ECMO策略,使用穿皮肺动脉通道 (输出) 和大腿静脉通道 (输入).
患者接受了为期7天的ECMO支持.

主要成果:

修改后的ECMO战略成功地支持了失败的RV和肺部.
患者在7天后从ECMO中断奶.
患者经历了一次平稳的康复,并被送回家.

结论:

经过修改的ECMO管道是对LVAD患者严重ARDS和VR衰竭的可行和有效治疗方法.
这种方法可以带来完全的恢复和成功的放电.
这一案例凸显了ECMO在复杂的心脏和呼吸系统情景中的适应性.

关键词:

在 COVID-19 疫情中,导管策略导管策略的使用在ECMO中,可以使用ECMO.在ECMO中使用道.身体外膜氧化器的氧化在LVAD和LVAD之间.

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