清醒体外膜肺氧合在重症患者中临床应用的利与弊  

Advantages and disadvantages of clinical application of awake extracorporeal membrane oxygenation in severe patients

作　　者：熊汝阳 王洪亮[1] 郑俊波[1] Xiong Ruyang;Wang Hongliang;Zheng Junbo(Department of Critical Care Medicine,the 2nd Affiliated Hospital of Harbin Medical University,Harbin 150086,China)

机构地区：[1]哈尔滨医科大学附属第二医院重症医学科,黑龙江哈尔滨150086

出　　处：《中国急救医学》2023年第8期610-613,共4页Chinese Journal of Critical Care Medicine

基　　金：国家重点研发计划(2021YFC2501800)。

摘　　要：重症患者中常有因呼吸衰竭和(或)循环衰竭而需要实施体外膜肺氧合(extracorporeal membrane oxygenation,ECMO)来维持心肺功能。保持重症患者处于清醒状态越来越受到重视,ECMO患者保持清醒状态也越来越多地应用于临床中,具有保持膈肌运动、避免插管及呼吸机相关并发症、减少镇静药物使用、减少谵妄、利于康复等优势,但对临床管理也提出了更高的要求,存在一定的风险需要加以防范。本文旨在对清醒ECMO的应用指征、实际应用及利弊进行综述,以促进临床对清醒ECMO患者的认知。Severe patients with respiratory and(or)circulatory failure often require extracorporeal membrane oxygenation(ECMO)to maintain cardiopulmonary function.Keeping critical patients awake is getting more and more attention,and keeping ECMO patients awake are increasingly used in clinical practice,which has the advantages of maintaining diaphragm movement,avoiding the complications related to intubation and ventilator,reducing the use of sedative drugs,reducing delirium,and facilitating rehabilitation.It also puts forward higher requirements for clinical management,and there are certain risks that need to be prevented.This article aims to review the indications,practical application,advantages and disadvantages of awake ECMO,so as to promote clinical cognition of awake ECMO patients.

关 键 词：体外膜肺氧合 清醒 重症疾病 镇痛 镇静 肌松 气管插管 

分 类 号：R459.7[医药卫生—急诊医学]