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在COVID-19中使用体外膜氧化:系统性审查
Marius Andrei Zavalichi1, Georgiana Ionescu1, Cătălina Marina Arsenescu Georgescu2
1Cardiology Department, Cardiovascular Diseases Institute "Prof. Dr. George I.M. Georgescu", University of Medicine and Pharmacy "Grigore T.Popa", Iași, Romania.
Archives of medical science : AMS
|July 31, 2025
概括
身体外膜氧化 (ECMO) 可能有助于COVID-19患有ARDS的患者,但结果差异很大. 需要进一步的研究来了解它的全部影响,并优化其在重症监护机构的使用.
科学领域:
- 关键护理医学 关键护理医学
- 支持心肺血管的支持.
- 传染性疾病 传染性疾病
背景情况:
- 随着COVID-19的蔓延,全球卫生面临重大挑战,影响着卫生系统和经济.
- 感染SARS-CoV-2可以导致多器官功能障碍,包括急性呼吸困扰综合征 (ARDS).
- 机械循环支持,如ECMO,对于在严重呼吸和心脏损害期间维持器官输液至关重要.
研究的目的:
- 系统地审查和评估体外膜氧化 (ECMO) 对COVID-19和ARDS患者的影响.
- 分析与ECMO使用相关的并发症,副作用和存活率.
主要方法:
- 从2019年12月到2021年10月,主要数据库 (PubMed,科学网,Embase,Cochrane,clinicaltrials.gov) 进行了系统的文献审查.
- 包括33项涉及4760名ECMO治疗的COVID-19患者的研究.
- 分析了患者并发症,不良事件和存活到出院的数据.
主要成果:
- 接受ECMO治疗的COVID-19患者在出院时的存活率在9%至90.6%之间有显著的差异.
- 报告的不良事件发生率很高,包括急性损伤 (高达87%),严重出血 (高达92.1%),中风/脑出血 (高达34%).
- 肺栓塞,外周出血和败血症等并发症大大影响了生存率.
结论:
- 对于患有ARDS的严重COVID-19患者来说,ECMO可以作为一种关键的救援疗法.
- 研究结果的显著变化和对SARS-CoV-2机制的不完全理解需要进一步研究.
- 优化ECMO协议和患者选择对于改善COVID-19重症监护的结果至关重要.
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