体外膜氧合与妊娠

IF 2.8 3区 医学 Q1 ANESTHESIOLOGY
M.J. Wong , B.S. Kodali , S. Rex
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引用次数: 0

摘要

由于生理变化、预先存在的条件和医疗保健差异之间的复杂相互作用,怀孕期间的危重疾病构成了重大挑战。在高收入国家,产妇年龄的增加和合并症使产科护理复杂化,导致怀孕期间心脏病发病率空前上升,而流感和COVID-19等感染是产妇成人呼吸窘迫综合征的重要原因。体外膜氧合(ECMO)作为一种重要的干预手段,在产前和产后的不同适应症中提供呼吸和/或心脏支持,得到了突出的地位。妊娠期的生理变化需要密切关注和调整ECMO参数,并需要多学科合作。尽管出血和血栓栓塞等潜在并发症需要警惕管理,妊娠期ECMO支持的最佳管理仍有待阐明,但ECMO仍能产生良好的母婴结局。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Extracorporeal membrane oxygenation and pregnancy
Critical illness during pregnancy poses significant challenges driven by complex interactions between physiological changes, pre-existing conditions, and healthcare disparities. In high-income countries, increasing maternal age and comorbidities complicate obstetric care by triggering an unprecedented rise in cardiac disease during pregnancy, while infections like influenza and COVID-19 are important causes of maternal adult respiratory distress syndrome. Extracorporeal membrane oxygenation (ECMO) gained prominence as a vital intervention, providing respiratory and/or cardiac support, for varying indications between antenatal and postpartum periods. The physiological changes of pregnancy demand close attention and adjustment of ECMO parameters, along with multidisciplinary collaboration. While potential complications such as bleeding and thromboembolism require vigilant management and optimal management of ECMO support in pregnancy still needs to be elucidated, ECMO nevertheless yields favorable maternal and fetal outcomes.
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