体外膜肺氧合是否可用于成人脓毒症和脓毒性休克的治疗  

Whether extracorporeal membrane oxygenation can be used in adult patients with sepsis and septic shock?

作　　者：余愿[1] 张红玲 尚游[1] Yu Yuan;Zhang Hongling;Shang You(Department of Critical Care Medicine,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430022,China)

机构地区：[1]华中科技大学同济医学院附属协和医院重症医学科,武汉430022

出　　处：《中华医学杂志》2022年第25期1899-1903,共5页National Medical Journal of China

摘　　要：脓毒症是世界范围内亟待解决的重大医疗问题。部分脓毒症患者存在难治性休克或合并严重呼吸衰竭,可能需要体外膜肺氧合(ECMO)治疗。在经验丰富的ECMO中心,选用合适的模式及把握启动的时机非常重要。模式的选择主要取决于患者的氧合及血流动力学状态。在ECMO运行期间的管理,需关注流量、抗凝和抗菌药物用法等问题。目前ECMO用于成人脓毒症和脓毒性休克的研究多为回顾、观察性,且样本量大多偏小,未来需要更深入的探索。Sepsis is a critical medical problem that needs to be solved urgently worldwide.Some patients with sepsis have refractory shock or/and severe respiratory failure,which may require supporting with extracorporeal membrane oxygenation(ECMO).Particularly,it is important to choose the optimal mode and grasp the optimal timing of the initiation in the experienced ECMO center.The choice of mode is mainly based on the patient′s condition of oxygenation and hemodynamics.During the management of ECMO support,some issues like blood flow,anticoagulation and therapy of antibiotics should be noted.Thus far,the research of ECMO in adult patients with sepsis and septic shock are mainly retrospective,observational and with small sample size.Further exploration is needed in the future.

关 键 词：体外膜氧合作用 脓毒症 脓毒性休克 成人 

分 类 号：R459.7[医药卫生—急诊医学]