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目前用于双边肺移植手术的手术内机械循环支持策略

Omar Toubat¹, Asad A Usman², Paulo Gregorio¹

¹Division of Cardiovascular Surgery, Department of Surgery, Hospital of the University of Pennsylvania, University of Pennsylvania, Philadelphia, Pa.

JTCVS techniques

|July 11, 2025

概括

本研究介绍了一种技术算法,用于在肺移植期间管理体外膜氧化 (ECMO). 它详细介绍了将各种ECMO配置转换为中央静脉ECMO/心肺绕道平台的策略.

科学领域:

心血管外科心血管外科
肺部医学肺部医学
移植手术移植手术

背景情况:

肺移植期间体外膜氧化 (ECMO) 的手术内管理带来了独特的技术挑战.
在复杂的肺移植手术中,有效的机械循环支持 (MCS) 对患者的结果至关重要.

研究的目的:

概述技术策略和考虑因素,以促进肺移植中的手术内ECMO管理.
建议在双边肺移植期间进行手术内ECMO转换的标准化算法.

主要方法:

审查该机构在双边肺移植期间对手术内ECMO管理的方法.
基于机械循环支持 (MCS) 平台的算法开发遇到.
用于将静脉 (VV),静脉肺 (VPa) 和静脉动脉 (VA) ECMO转换为中央VA ECMO/心肺旁路 (CPB) 平台的转换技术的描述.

主要成果:

对于没有手术前支持的患者,需要对手术内ECMO的指示和配置进行评估.
具体策略详细介绍了孤立呼吸衰竭 (VV ECMO),肺高血压/RV功能障碍 (VA ECMO) 以及桥梁VV,VPa或VA ECMO的患者.
一个经过修改的电路允许从VA ECMO快速转换为全CPB.

结论:

提出了一种技术上可行的算法,用于在肺移植期间进行各种ECMO配置的手术内转换.
该算法促进了向中央VA ECMO/CPB平台的无过渡,优化了复杂程序中的支持.

关键词:

在ECMO中,可以使用ECMO.VA ECMO ECMO ECMO ECMO ECMO ECMO ECMO ECMO ECMO ECMO ECMO ECMO ECMO ECMO ECMO ECMO ECMO ECMO ECMO ECMO ECMO ECMO ECMO ECMO ECMO ECMO ECMO ECMO ECMO ECMO ECMO ECMO ECMO ECMO ECMO ECMO ECMO ECMO ECMO ECMO ECMO ECMO ECMO ECMO ECMO ECMO ECMO ECMO ECMO ECMO ECMO ECMO ECMO ECMO ECMO ECMO ECMO ECMO ECMO ECMO ECMO ECMO ECMO ECMO ECMO ECMO ECMO ECMO ECMO ECMO ECMO ECMO ECMO ECMO ECMO ECMO ECMO ECMO ECMO ECMO ECMO ECMO ECMO ECMO ECMO 在VV ECMO中使用.身体外膜氧化氧化肺部移植肺部移植右心室辅助装置的使用.

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