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Veno-Venous Extracorporeal Membrane Oxygenation in a Mouse
Published on: October 24, 2018
静脉动脉外体膜氧化的氧化
Uwe Zeymer1,2, Dirk Westermann1
1Department of Cardiology and Angiology, University Heart Center Freiburg-Bad Krozingen, Faculty of Medicine, University of Freiburg, Freiburg.
在急性心肌梗塞心脏性休克中,常规使用静脉动脉外体膜氧化 (VA-ECMO) 不能提高存活率. 这种方法增加了出血和缺血并发症,这表明保守的策略是最好的.
科学领域:
- 心脏病学 心脏病学
- 临界护理医学 临界护理医学
- 心血管干预 心血管干预
背景情况:
- 由于急性心肌梗塞引起的心脏性休克,尽管有先进的治疗方法,但死亡率很高.
- 机械循环支持,包括静脉动脉外体膜氧化 (VA-ECMO),越来越多地使用.
- VA-ECMO通过皮肤植入提供外部氧化和循环支持.
研究的目的:
- 审查目前关于VA-ECMO在心脏性休克中使用的证据.
- 评估VA-ECMO在该患者群体中的疗效和安全性.
主要方法:
- 分析了四项随机临床试验,包括ECLS-SHOCK试验 (417名患者).
- 包括两个个体患者数据元分析.
- 关于VA-ECMO在心脏病相关心脏病性休克中的证据的审查.
主要成果:
- 在常规使用VA-ECMO时,没有观察到死亡益处.
- 观察到出血和外周血管缺血并发症的持续增加.
- 对于脑损伤风险低的STEMI患者或需要氧化的人来说,可能存在潜在的益处.
结论:
- 常规的,未经选择的早期VA-ECMO在与心脏病相关的心脏性休克中没有得到当前证据的支持.
- 在ECLS-SHOCK试验和元分析倡导一个保守的方法.
- 仔细的患者选择对于考虑VA-ECMO治疗至关重要.
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