Respiratory extracorporeal membrane oxygenation : From rescue therapy to standard tool for treatment of acute respiratory distress syndrome?

IF 1.3 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Medizinische Klinik-Intensivmedizin Und Notfallmedizin Pub Date : 2024-07-01 Epub Date: 2024-03-08 DOI:10.1007/s00063-024-01118-y

Richard Greendyk, Rahul Kanade, Madhavi Parekh, Darryl Abrams, Philippe Lemaitre, Cara Agerstrand

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引用次数: 0

Abstract

Background: The use of extracorporeal membrane oxygenation (ECMO) for patients with acute respiratory distress syndrome (ARDS) has increased substantially. With modern trials supporting its efficacy, ECMO has become an important tool in the management of severe ARDS.

Objectives: The objectives of this paper are to discuss ECMO physiology and configurations used for patients with ARDS, review evidence supporting the use of ECMO for ARDS, and discuss aspects of management during ECMO.

Conclusion: Current evidence supports the use of ECMO, combined with an ultra-lung-protective approach to mechanical ventilation, in patients with ARDS who have refractory hypoxemia or hypercapnia with severe respiratory acidosis. Furthermore, data suggest that center volume and experience are important factors in the care of patients receiving ECMO. The use of extracorporeal technologies in expanded patient populations and the optimal management of patients during ECMO remain areas of investigation. This article is freely available.

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呼吸体外膜氧合：从抢救疗法到治疗急性呼吸窘迫综合征的标准工具？

背景：体外膜肺氧合（ECMO）在急性呼吸窘迫综合征（ARDS）患者中的应用大幅增加。现代试验支持其疗效，ECMO 已成为治疗严重 ARDS 的重要工具：本文旨在讨论用于 ARDS 患者的 ECMO 生理和配置，回顾支持将 ECMO 用于 ARDS 的证据，并讨论 ECMO 期间的管理问题：结论：目前的证据支持在患有难治性低氧血症或高碳酸血症并伴有严重呼吸性酸中毒的 ARDS 患者中使用 ECMO，并结合超肺保护方法进行机械通气。此外，数据表明，中心的规模和经验是护理接受 ECMO 患者的重要因素。体外循环技术在更多患者中的应用以及 ECMO 期间对患者的最佳管理仍是需要研究的领域。本文可免费获取。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Medizinische Klinik-Intensivmedizin Und Notfallmedizin MEDICINE, GENERAL & INTERNAL-

CiteScore

2.60

自引率

9.10%

发文量

审稿时长

6-12 weeks

期刊介绍： Medizinische Klinik – Intensivmedizin und Notfallmedizin is an internationally respected interdisciplinary journal. It is intended for physicians, nurses, respiratory and physical therapists active in intensive care and accident/emergency units, but also for internists, anesthesiologists, surgeons, neurologists, and pediatricians with special interest in intensive care medicine. Comprehensive reviews describe the most recent advances in the field of internal medicine with special focus on intensive care problems. Freely submitted original articles present important studies in this discipline and promote scientific exchange, while articles in the category Photo essay feature interesting cases and aim at optimizing diagnostic and therapeutic strategies. In the rubric journal club well-respected experts comment on outstanding international publications. Review articles under the rubric "Continuing Medical Education" present verified results of scientific research and their integration into daily practice. The rubrics "Nursing practice" and "Physical therapy" round out the information.