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在复杂的气管支气管切除中,静脉-静脉外体膜氧化
Luca Voltolini1,2, Alberto Salvicchi1, Alessandro Gonfiotti1,2
1Thoracic Surgery Unit, Careggi University Hospital, Florence, Italy.
Journal of thoracic disease
|March 20, 2024
概括
内手术静脉静脉 (VV) ECMO (体外膜氧化) 安全地支持复杂的主气道手术. 这种技术最大限度地减少并发症,并允许通风中断,改善患者在具有挑战性的胸部手术中的结果.
科学领域:
- 胸部外科手术 胸部外科手术
- 支持心肺血管的支持.
- 航空航道重建 航空航道重建
背景情况:
- 选择性体外膜氧化 (ECMO) 很少用于胸部手术,但不包括肺移植.
- 静脉静脉 (VV) ECMO是复杂的气道程序的新兴支持模式.
研究的目的:
- 评估在选定的主要气道手术中使用手术内VV-ECMO的机构经验.
- 在复杂的胸部手术中评估VV-ECMO的安全性和有效性.
主要方法:
- 在VV-ECMO支持下进行主气道手术的10名患者的回顾性分析 (2013年6月 - 2022年8月).
- 程序包括切除,袖叶切除,气管修复和气管切除术后狭窄的切除.
主要成果:
- 在手术期间使用VV-ECMO的中位数为162.5分钟.
- 在复杂的情况下,高流量VV-ECMO使通风中断持续长达3小时.
- 没有观察到术后死亡或ECMO相关的并发症.
- 所有10名患者均存活下来,平均随访时间为30个月;一名患者出现了轻微的静脉并发症.
结论:
- 术内VV-ECMO可促进安全和精确的主要呼吸道手术,包括复杂的切除和重建.
- 这种技术对那些无法承受常规通风的患者有好处.
- 使用VV-ECMO与手术后发病率最小和长期生存率有利有关.
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