在急性呼吸衰竭中ECMO与非ECMO治疗后的长期肺功能恢复:系统性审查和元分析
1Department of Intensive Care Medicine, No.903 Hospital of PLA Joint Logistic Support Force, Hangzhou, China.
BMC pulmonary medicine
|October 10, 2024
概括
与传统通风相比,体外膜氧化 (ECMO) 可能为急性呼吸衰竭 (ARF) 患者提供类似的长期肺功能恢复. 需要更多的研究来证实这些发现对ARF治疗结果.
科学领域:
- 关键护理医学 关键护理医学
- 肺部病理学 肺部病理学
- 呼吸系统生理学 呼吸系统生理学
背景情况:
- 体外膜氧化 (ECMO) 越来越多地用于急性呼吸衰竭 (ARF).
- 与传统机械通风相比,ECMO的长期结果和肺复原效应仍然不清楚.
- 本综述研究了使用ECMO和不使用ECMO治疗的ARF患者的长期肺功能.
研究的目的:
- 为了比较使用ECMO治疗的ARF患者的长期肺功能测试结果与传统策略.
- 综合现有的关于ECMO对ARF后肺部恢复的影响的证据.
主要方法:
- 在Embase,CENTRAL,Web of Science和PubMed的系统文献搜索到2024年1月.
- 包括在ARF患者中报告长期 (≥6个月) 肺功能测试的研究.
- 对关键肺功能参数的百分比预测值的元分析.
主要成果:
- 五项研究的元分析显示,ECMO和非ECMO组之间的强迫生命能力 (FVC%) 和强迫呼气流在第一秒% (FEV1%) 中相似.
- 在ECMO组中观察到略高的FEV1/FVC% (p=0.05).
- 总肺容量%和一氧化碳扩散能力%在各组之间是可比的.
结论:
- 对ARF的ECMO治疗可能会导致与传统方法相比的长期肺功能恢复.
- 目前的证据受到少数研究和潜在的选择偏差的限制.
- 需要进一步进行大规模的研究,以巩固ECMO对肺部恢复的长期影响.
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