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Structured review of post-cardiotomy extracorporeal membrane oxygenation: part 1-Adult patients.
The Journal of Heart and Lung Transplantation ( IF 8.9 ) Pub Date : 2019-08-10 , DOI: 10.1016/j.healun.2019.08.014
Roberto Lorusso , Giuseppe Maria Raffa , Khalid Alenizy , Niels Sluijpers , Maged Makhoul , Daniel Brodie , Mike McMullan , I-Wen Wang , Paolo Meani , Graeme MacLaren , Mariusz Kowalewski , Heidi Dalton , Ryan Barbaro , Xiaotong Hou , Nicholas Cavarocchi , Yih-Sharng Chen , Ravi Thiagarajan , Peta Alexander , Bahaaldin Alsoufi , Christian A. Bermudez , Ashish S. Shah , Jonathan Haft , David A. D'Alessandro , Udo Boeken , Glenn J.R. Whitman

Cardiogenic shock, cardiac arrest, acute respiratory failure, or a combination of such events, are all potential complications after cardiac surgery which lead to high mortality. Use of extracorporeal temporary cardio-circulatory and respiratory support for progressive clinical deterioration can facilitate bridging the patient to recovery or to more durable support. Over the last decade, extracorporeal membrane oxygenation (ECMO) has emerged as the preferred temporary artificial support system in such circumstances. Many factors have contributed to widespread ECMO use, including the relative ease of implantation, effectiveness, versatility, low cost relative to alternative devices, and potential for full, not just partial circulatory support. While there have been numerous publications detailing the short and midterm outcomes of ECMO support, specific reports about post-cardiotomy ECMO (PC-ECMO), are limited, single-center experiences. Etiology of cardiorespiratory failure leading to ECMO implantation, associated ECMO complications, and overall patient outcomes may be unique to the PC-ECMO population. Despite the rise in PC-ECMO use over the past decade, short-term survival has not improved.

This report, therefore, aims to present a comprehensive overview of the literature with respect to the prevalence of ECMO use, patient characteristics, ECMO management, and in-hospital and early post-discharge patient outcomes for those treated for post-cardiotomy heart, lung, or heart-lung failure.



中文翻译:

心脏切除术后体外膜氧合的结构性综述:第1部分-成人患者。

心源性休克,心脏骤停,急性呼吸衰竭或这些事件的组合,都是心脏手术后可能导致高死亡率的潜在并发症。为进行性临床恶化而使用体外临时心脏循环和呼吸支持可以促进患者桥接以恢复或获得更持久的支持。在过去的十年中,在这种情况下,体外膜氧合(ECMO)已经成为首选的临时人工支持系统。许多因素促成ECMO的广泛使用,包括植入的相对容易性,有效性,多功能性,相对于替代装置的低成本以及潜在的全面(而不仅仅是部分)循环支持。尽管有许多出版物详细介绍了ECMO支持的短期和中期结果,有关心脏切除术后ECMO(PC-ECMO)的具体报告是有限的,单中心的经验。导致ECMO植入的心肺衰竭的病因,相关的ECMO并发症以及总体患者预后可能是PC-ECMO人群所独有的。尽管在过去十年中PC-ECMO的使用有所增加,但短期生存率并未提高。

因此,本报告旨在针对心脏切开术后心脏,肺部治疗的患者,全面介绍ECMO的使用率,患者特征,ECMO管理以及院内和出院后早期患者的结局。 ,或心肺衰竭。

更新日期:2019-08-10
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