2023年体外生命支持临床研究回顾  

Annual review of clinical research on extracorporeal life support in 2023

作　　者：张红玲 余愿[1] 陈德昌 尚游[1] Zhang Hongling;Yu Yuan;Chen Dechang;Shang You(Department of Critical Care Medicine,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430022,Hubei,China;Department of Critical Care Medicine,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 201800,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,湖北武汉430022 [2]上海交通大学医学院附属瑞金医院北院重症医学科,上海201800

出　　处：《中华危重病急救医学》2024年第2期118-123,共6页Chinese Critical Care Medicine

基　　金：湖北省重点研发计划项目(2023BCB091)。

摘　　要：2023年体外生命支持(ECLS)领域的临床研究关注了静脉-动脉体外膜肺氧合(ECMO)在急性心肌梗死合并心源性休克患者中的应用价值。此外,研究还探讨了静脉-静脉ECMO期间俯卧位的疗效,以及抗凝治疗、输血策略、肥胖对患者预后的影响。清醒状态下静脉-静脉ECMO展现出新的治疗潜力,但其最佳实践方法和管理策略仍需进一步研究。在院内心搏骤停患者中,体外心肺复苏相对于传统心肺复苏表现出更优的生存率和神经功能恢复。体外二氧化碳清除在不同类型的呼吸衰竭患者中疗效不同。未来的研究方向应聚焦如何优化ECLS技术的应用策略、过程管理,深入研究个体化治疗方法,并全面研究如何改善幸存者的远期康复和生活质量。The clinical research in the field of extracorporeal life support(ECLS)in 2023 has focused on the efficacy of veno-arterial extracorporeal membrane oxygenation(ECMO)in patients with infarct-related cardiogenic shock.Additionally,the research also explored the efficacy of prone positioning during veno-venous ECMO,transfusion strategies,and the impact of obesity on outcomes.Awake veno-venous ECMO has shown novel therapeutic potential,but its optimal practice methods and management strategies remain to be determined.In in-hospital cardiac arrest patients,extracorporeal cardiopulmonary resuscitation has demonstrated higher survival rates and better neurological recovery compared to conventional cardiopulmonary resuscitation.The effectiveness of extracorporeal carbon dioxide removal varies among patients with different types of respiratory failure.Future research should focus on optimizing the application strategies and process management of ECLS technologies,investigating personalized therapy,and studying how to improve long-term rehabilitation and quality of life for survivors.

关 键 词：体外生命支持 静脉-动脉体外膜肺氧合 静脉-静脉体外膜肺氧合 体外心肺复苏 体外二氧化碳清除 临床结局 

分 类 号：R459.7[医药卫生—急诊医学]