在急性严重喘中体外生命支持 (ECLS) 的结果:叙述性审查
Nneoma Ekechukwu1, Sachin Batra2, Deborah Orsi1
1Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY, USA.
Lung
|March 21, 2024
概括
身体外生命支持 (ECMO和ECCO2R) 为机械呼吸的严重喘患者提供救援疗法,总死亡率为17%. 需要进一步的研究来优化其使用和患者选择.
科学领域:
- 临界护理医学 临界护理医学
- 呼吸系统医学 呼吸系统医学
- 支持心肺血管的支持.
背景情况:
- 需要机械通风的喘状态是一个关键的挑战.
- 包括ECMO和ECCO2R在内的体外生命支持被探索为救援疗法.
- 了解结果对于管理严重喘恶化至关重要.
研究的目的:
- 审查机械通风状态喘患者体外膜氧化 (ECMO) 和体外二氧化碳去除 (ECCO2R) 的结果.
- 探索这些救援疗法的疗效和并发症.
- 确定进一步研究和优化的潜在领域.
主要方法:
- 对多个数据库进行了叙述性审查.
- 包括的研究报告了急性严重喘 (ASA) 患者ECMO/ECCO2R的死亡率和并发症.
- 使用Poisson的正常建模,得出了聚合估计.
主要成果:
- 分析了六项回顾性研究.
- 聚合死亡率为17% (13-20%).
- 并发症包括出血 (22%),机械问题 (26%),感染 (8%) 和肺胸部 (4%).
结论:
- 在ECMO/ECCO2R启动和患者选择喘状态方面存在差异.
- 报告的死亡率相对较低,可能受到选择偏差的影响.
- 需要进行进一步的研究,以确定严重喘中ECMO/ECCO2R的最佳风险益益比.
更多相关视频
03:40Point-of-Care Ultrasound for Peripheral Veno-Arterial Extracorporeal Membrane Oxygenation Without Left Ventricular Venting
Published on: January 17, 2025
289
06:22Surfactant Depletion Combined with Injurious Ventilation Results in a Reproducible Model of the Acute Respiratory Distress Syndrome ARDS
Published on: April 7, 2021
3.4K
相关概念视频
Acute Respiratory Failure-V
137
The treatment for acute respiratory failure varies based on factors like the underlying cause, overall health, and severity. A collaborative healthcare team is essential for early detection, often through arterial blood gas analysis. Identifying the cause is the primary goal, with treatment strategies adjusted for ventilation/perfusion (V/Q) mismatch, shunting, or diffusion impairment.
Ensure that patients are monitored continuously for their response to therapy, including changes in...
Ensure that patients are monitored continuously for their response to therapy, including changes in...
137
Acute Respiratory Failure-III
184
Hypercapnic respiratory failure, also known as Type 2 or ventilatory respiratory failure, is a severe condition characterized by the body's inability to effectively remove carbon dioxide (CO2) from the bloodstream. It leads to an arterial CO2 pressure (PaCO2) exceeding 45 mmHg and a blood pH above 7.35. This situation indicates that the body's ventilatory demand, or the ventilation needed to maintain normal PaCO2 levels, surpasses its supply or the maximum gas flow achievable without...
184
Asthma-III: Symptoms and Complications
2.5K
Asthma, a common chronic respiratory condition, is classified considering the frequency and severity of symptoms alongside lung function impairment. Understanding this classification is essential for appropriate treatment and management. Here's a detailed look at the classification of asthma and its clinical features and complications:
Classification of Asthma
Classification of Asthma
2.5K
Acute Respiratory Failure-I
204
Acute respiratory failure is a condition characterized by the inability of the lungs to perform their primary function: gas exchange. This failure leads to insufficient oxygen levels (hypoxemia) in the blood, elevated carbon dioxide levels (hypercapnia), or both, causing critical impairment in organ function.
Definition: It is defined by specific criteria based on blood gas measurements. Hypoxemia happens when the partial pressure of oxygen (PaO2) falls below 60 mmHg. At the same time,...
Definition: It is defined by specific criteria based on blood gas measurements. Hypoxemia happens when the partial pressure of oxygen (PaO2) falls below 60 mmHg. At the same time,...
204
Endotracheal Tube Extubation
641
Endotracheal tube extubation is a critical procedure in weaning patients from mechanical ventilation. It involves physically removing the oral or nasal endotracheal (ET) tube, marking the final step in liberating a patient from ventilatory support.
Procedure
Extubation removes the endotracheal tube (ETT) from the patient on mechanical ventilation. It requires a well-coordinated, multidisciplinary approach involving physicians, nurses, respiratory therapists, and other healthcare professionals....
Procedure
Extubation removes the endotracheal tube (ETT) from the patient on mechanical ventilation. It requires a well-coordinated, multidisciplinary approach involving physicians, nurses, respiratory therapists, and other healthcare professionals....
641
Acute Respiratory Failure-II
222
Type I Respiratory Failure, or hypoxemic respiratory failure, occurs when the partial pressure of oxygen (PaO2) in arterial blood falls below 60 mmHg while breathing room air without a corresponding increase in arterial carbon dioxide levels (PaCO2). This condition highlights a significant impairment in the lungs' capacity to oxygenate the blood.
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include:
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include:
222
