A new miniaturized system for extracorporeal membrane oxygenation in adult respiratory failure.
A new miniaturized system for extracorporeal membrane oxygenation in adult respiratory failure.
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DOI：
10.1186/cc8213
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发表时间：
2009
期刊：
影响因子：
--
通讯作者：
Lubnow M
中科院分区：
文献类型：
--
作者：
Müller T;Philipp A;Luchner A;Karagiannidis C;Bein T;Hilker M;Rupprecht L;Langgartner J;Zimmermann M;Arlt M;Wenger J;Schmid C;Riegger GA;Pfeifer M;Lubnow M
成人严重急性呼吸窘迫综合征的死亡率仍然高得令人无法接受。如果通过新技术的发展减少并发症，体外膜肺氧合（ECMO）可能是一种重要的治疗选择。在60例连续危及生命的呼吸衰竭患者中，分析了使用新型微型静脉-静脉体外气体转移装置治疗的效率、副作用和结局。体外支持开始后，动脉氧分压/吸入氧分数（PaO 2/FiO 2）从64（48至86）mmHg迅速增加至120（84至171）mmHg，PaCO 2从63（50至80）mmHg下降至33（29至39）mmHg（P < 0.001）。该装置的气体交换能力对于氧气平均为155（116至182）mL/min，对于二氧化碳平均为210（164至251）mL/min。将通气参数降低至高度保护模式，允许潮气量从495（401至570）mL快速降低至336（292至404）mL（P < 0.001），吸气峰压从36（32至40）cmH 2 O快速降低至31（28至35）cmH 2 O（P < 0.001）。输血需求平均为每天0.8（0.4至1.8）单位的红细胞。62%的患者脱离体外系统，45%存活出院。采用新型小型化装置的静脉-静脉体外膜氧合可有效支持气体输送，实现高度保护性通气，并且非常可靠。现代ECMO技术扩大了严重肺衰竭的治疗机会。
Mortality of severe acute respiratory distress syndrome in adults is still unacceptably high. Extracorporeal membrane oxygenation (ECMO) could represent an important treatment option, if complications were reduced by new technical developments. Efficiency, side effects and outcome of treatment with a new miniaturized device for veno-venous extracorporeal gas transfer were analysed in 60 consecutive patients with life-threatening respiratory failure. A rapid increase of partial pressure of arterial oxygen/fraction of inspired oxygen (PaO2/FiO2) from 64 (48 to 86) mmHg to 120 (84 to 171) mmHg and a decrease of PaCO2 from 63 (50 to 80) mmHg to 33 (29 to 39) mmHg were observed after start of the extracorporeal support (P < 0.001). Gas exchange capacity of the device averaged 155 (116 to 182) mL/min for oxygen and 210 (164 to 251) mL/min for carbon dioxide. Ventilatory parameters were reduced to a highly protective mode, allowing a fast reduction of tidal volume from 495 (401 to 570) mL to 336 (292 to 404) mL (P < 0.001) and of peak inspiratory pressure from 36 (32 to 40) cmH2O to 31 (28 to 35) cmH2O (P < 0.001). Transfusion requirements averaged 0.8 (0.4 to 1.8) units of red blood cells per day. Sixty-two percent of patients were weaned from the extracorporeal system, and 45% survived to discharge. Veno-venous extracorporeal membrane oxygenation with a new miniaturized device supports gas transfer effectively, allows for highly protective ventilation and is very reliable. Modern ECMO technology extends treatment opportunities in severe lung failure.
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影响因子：
1.2
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