[2024年体外生命支持临床研究年度回顾]。

Q3 Medicine
Hongling Zhang, Yuan Yu, Zhongtao Du, Xiaojing Zou, Xiaotong Hou, You Shang
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引用次数: 0

摘要

2024年体外生命支持(ECLS)领域的重要研究集中在心脏支持技术在急性心肌梗死(AMI)合并心源性休克(CS)中的应用:静脉-动脉体外膜氧合(V-A ECMO)在短期或长期结局中均未显示出优势,可能增加出血和血管并发症的风险;相比之下,微轴流泵显示出提高死亡率的潜力。静脉-静脉体外膜氧合(V-V ECMO)联合俯卧位治疗严重急性呼吸窘迫综合征(ARDS)的效果尚不明确。体外心肺复苏(ECPR)在院外心脏骤停(OHCA)患者中的生存益处已得到进一步验证。体外二氧化碳去除(ECCO2R)的潜在益处需要进一步研究。此外,2024年发布的新指南侧重于ECMO期间的神经监测和管理,以及静脉-静脉ECMO期间右心室损伤的定义和管理。ECMO管理需要更精细的策略,包括优化氧合目标、抗凝、输血和脱机策略,以改善患者的预后。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Annual review of clinical research on extracorporeal life support in 2024].

The important studies in the field of extracorporeal life support (ECLS) in 2024 focused on the application of cardiac support technologies in acute myocardial infarction (AMI) with cardiogenic shock (CS): veno-arterial extracorporeal membrane oxygenation (V-A ECMO) has not shown advantages in either short- or long-term outcomes and may increase the risk of bleeding and vascular complications; in contrast, micro-axial flow pumps demonstrate potential in improving mortality. The effects of veno-venous extracorporeal membrane oxygenation (V-V ECMO) combined with prone positioning on severe acute respiratory distress syndrome (ARDS) remain uncertain. The survival benefit of extracorporeal cardiopulmonary resuscitation (ECPR) in out-of-hospital cardiac arrest (OHCA) patients has been further validated. The potential benefits of extracorporeal carbon dioxide removal (ECCO2R) require further investigation. Additionally, new guidelines released in 2024 focus on Neurological monitoring and management during ECMO, as well as the Definition and management of right ventricular injury during veno-venous ECMO. ECMO management requires more refined strategies, including optimized oxygenation targets, anticoagulation, blood transfusion, and weaning strategies to improve patient outcomes.

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来源期刊
Zhonghua wei zhong bing ji jiu yi xue
Zhonghua wei zhong bing ji jiu yi xue Medicine-Critical Care and Intensive Care Medicine
CiteScore
1.00
自引率
0.00%
发文量
42
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