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首页 > 医学词汇大全 > Extracorporeal membrane oxygenation
Extracorporeal membrane oxygenation

心血管

关键词心血管 治疗方法 辅助心脏手术

词汇介绍

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解析

Extracorporeal /,ekstrəkɔː'pɔːrɪəl/ 

释义   adj. 身体外面的

例句   In some cases, extracorporeal shock wave lithotripsy may be combined with other forms of treatment.

在某些情况下体外震波碎石术可以与其他形式的治疗相结合

 

membrane /'membreɪn/  /'mɛmbren/ 

释义   n. 膜;薄膜;羊皮纸

例句   Once the toxin perforates the host membrane, ions begin to leak out of the cell. 

一旦毒素穿孔于宿主细胞膜离子便开始细胞中

 

oxygenation /,ɑksədʒə'neʃən/ 

释义   n. 以氧处理,氧化作用

例句   It shows that the oxygenation of the sodium nitrate is obvious to cerium.

结果证明,硝酸钠对铈的氧化作用是显著的

概述

机械性心肺支持技术最常用于术中以辅助心脏手术的实施(即体外循环)。长时间心肺支持技术被称为体外膜肺氧合(extracorporeal membrane oxygenation, ECMO)、体外生命支持或体外肺辅助。通常应用于重症监护病房(ICU)。ECMO只应由具备相应设备和专业技术的医疗中心进行。 模式ECMO有2种模式,静-静脉(VV)和静-动脉(VA)模式。VV ECMO用于呼吸衰竭患者的治疗,而VA ECMO用于心功能衰竭患者的治疗。 适应症尽管优化了包括潮气量

Extracorporeal membrane oxygenation: indications, technique and contemporary outcomes复制标题

体外膜肺氧合: 适应症、技术和当代结果

发表时间:2019-04-30

影响因子:5.1

作者: Jason Ali

期刊:Heart

Extracorporeal membrane oxygenation (ECMO) is a type of prolonged mechanical cardiopulmonary support that is usually delivered in the intensive care unit. ECMO should only be performed in centers with the appropriate equipment and expertise. The only absolute contraindaication to ECMO is a pre-existing condition which is incompatible with recovery (severe neurologic injury, end stage malignancy). Relative contraindications include uncontrollable bleeding and very poor prognosis from the primary condition. Results in respiratory failure are better when ECMO is instituted within seven days of intubation. ECMO is being increasingly used. ECMO should only by performed by clinicians with training and experience in its initiation, maintenance, and discontinuation. During ECMO, blood is drained from the native vascular system, circulated outside the body by a mechanical pump, and reinfused into the circulation. While outside the body, the blood passes through an oxygenator and heat exchanger. In the oxygenator, hemoglobin becomes fully saturated with oxygen, while carbon dioxide (CO2) is removed. Oxygenation is determined by flow rate, where elimination of CO2 can be controlled by adjusting the rate of countercurrent gas flow through the oxygenator. Once it has been determined that ECMO will be initiated, the patient is anticoagulated. Cannulae are then inserted and the patient is connected to the ECMO circuit. The blood flow is increased until respiratory and hemodynamic parameters are satisfactory. Once the initial respiratory and hemodynamic goals have been achieved, blood flow is maintained, ventilator support is minimized, and vasoactive drugs are decreased to minimal levels. Frequent reassessment and adjustments are usually necessary.

译文

体外膜肺氧合(ECMO)是一种延长的机械心肺支持,通常在重症监护病房进行。 ECMO只应在具有适当设备和专业知识的中心进行。对ECMO唯一的绝对禁忌症是既往病症,与恢复(严重的神经损伤,终末期恶性肿瘤)不相容。相对禁忌症包括无法控制的出血和原发病情预后非常差。在插管后7天内开始ECMO时,呼吸衰竭的结果更好。ECMO正在被越来越多地使用。 ECMO应仅由具有培训和启动,维护和停止经验的临床医生执行。在ECMO期间,血液从天然血管系统排出,通过机械泵在体外循环,并重新注入循环。在身体外,血液通过氧合器和热交换器。在氧合器中,血红蛋白完全被氧饱和,而二氧化碳(CO2)被除去。通过流速确定氧合作用,其中可以通过调节通过氧合器的逆流气体流速来控制CO 2的消除。一旦确定将启动ECMO,患者就会抗凝。然后插入针头并将患者连接到ECMO回路。血流增加直到呼吸和血液动力学参数令人满意。一旦达到最初的呼吸和血液动力学目标,就保持血流量,最小化呼吸机支持,并将血管活性药物降低到最低水平。通常需要经常进行重新评估和调整。