体外膜肺氧合在心源性休克救治中的应用  

Veno-arterial extracorporeal membrane oxygenation in salvage of cardiogenic shock

作　　者：梁影 姜福清 黑飞龙[1] LIANG Ying;JIANG Fuqing;HEI Feilong(Department of Extracorporeal Circulation,Fuwai Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing,100037,P.R.China;Department of Extracorporeal Circulation,Fuwai Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Shenzhen,518057,Guangdong,P.R.China)

机构地区：[1]中国医学科学院北京协和医学院国家心血管病中心阜外医院体外循环中心,北京100037 [2]中国医学科学院阜外医院深圳医院体外循环科,广东深圳518057

出　　处：《中国胸心血管外科临床杂志》2021年第11期1365-1370,共6页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

基　　金：国家自然科学基金(81670077);中国医学科学院医学与健康科技创新工程项目(2020-I2M-C&T-B-066);北京协和医学院研究生创新基金(2020-I2M-C&T-B-066)。

摘　　要：心源性休克是由于左、右或双心室衰竭导致低心输出量引起循环的衰竭状态,致死率极高。近年来,体外膜肺氧合(extracorporeal membrane oxygenation,ECMO)因其便携、辅助流量大、专家熟悉度高、可同时提供心肺支持等优点,成为维持心源性休克短期血流动力学稳定的首选设备,帮助器官渡过恢复期以及移植等待期或作为进一步决策的桥梁。本文就ECMO在心源性休克治疗中的适应证、管理策略及未来应用领域进行综述,为临床实践提供相关参考。Cardiogenic shock(CS) describes a physiological state of end-organ hypoperfusion characterized by reduced cardiac output in the presence of adequate intravascular volume. Mortality still remains exceptionally high. Venoarterial extracorporeal membrane oxygenation(VA ECMO) has become the preferred device for short-term hemodynamic support in patients with CS. ECMO provides the highest cardiac output, complete cardiopulmonary support. In addition, the device has portable characteristics, more familiar to medical personnel. VA ECMO provides cardiopulmonary support for patients in profound CS as a bridge to myocardial recovery. This review provides an overview of VA ECMO in salvage of CS, emphasizing the indications, management and further direction.

关 键 词：体外膜肺氧合 心源性休克 急性心肌梗死 心脏移植 心脏手术 体外心肺复苏 新型冠状病毒肺炎 

分 类 号：R541.64[医药卫生—心血管疾病]