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A single center experience of using ECMO in anesthesia for lung transplantation 单中心ECMO在肺移植麻醉中的应用体会
Q4 Medicine Pub Date : 1900-01-01 DOI: 10.14188/j.1671⁃8852.2021.6005
Y. Wu, L. Tang, L. Zhan, Zhengyuan Xia
Objective: To explore the use of extracorporeal membrane oxygenation(ECMO) during lung transplantation anesthesia, and summarize the experience. Methods: From December 2016 to December 2020, the clinical data of 19 patients with lung transplantation using ECMO during anesthesia in Renmin Hospital of Wuhan University were retrospectively analyzed. Results: Among the 19 patients, the main diagnosis were chronic obstructive pulmonary diseases in 5 cases, idiopathic pulmonary fibrosis in 6 cases, bronchiectasis in 2 cases, pneumoconiosis in 4 cases, Kartagener syndrome in 1 case, and COVID-19 with advanced pulmonary fibrosis in 1 case. A total of 9 patients used ECMO to complete the operation. ECMO was used in 2 cases before anesthesia and 7 cases received ECMO treatment after anesthesia. Among them, 5 cases were veno-venous (V-V) ECMO and 4 cases were veno-arterial (V-A) ECMO. During operation, V-A ECMO was changed to veno-artery-vein (V-A-V) ECMO in 1 case, another case used V-V plus V-A ECMO. After operation, 4 cases removed ECMO successfully and returned to the intensive care unit, and 5 cases took ECMO back to the intensive care unit. Among them, 4 cases removed ECMO successfully and 1 case failed due to multiple infections. Among the 10 patients who did not receive ECMO, 1 patient had cardiac arrest during the operation. Conclusion: ECMO is an important auxiliary tool in lung transplantation. Accurate evaluation of patients' cardiopulmonary function and use of ECMO, according to their oxygenation and circulatory status, can provide effective support for lung transplantation anesthesia. © 2021, Editorial Board of Medical Journal of Wuhan University. All right reserved.
目的:探讨体外膜氧合(ECMO)在肺移植麻醉中的应用,并总结经验。方法:回顾性分析2016年12月至2020年12月武汉大学人民医院19例麻醉下ECMO肺移植患者的临床资料。结果:19例患者中,主要诊断为慢性阻塞性肺疾病5例,特发性肺纤维化6例,支气管扩张2例,尘肺4例,Kartagener综合征1例,COVID-19合并晚期肺纤维化1例。共有9例患者采用ECMO完成手术。麻醉前ECMO 2例,麻醉后ECMO 7例。其中静脉-静脉(V-V) ECMO 5例,静脉-动脉(V-A) ECMO 4例。术中1例V-A ECMO改为静脉-动脉-静脉(V-A- v) ECMO, 1例V-V + V-A ECMO。术后4例成功取出ECMO返回重症监护病房,5例再次取出ECMO返回重症监护病房。其中4例成功取出ECMO, 1例因多发感染未能取出。未行ECMO的10例患者中,术中出现1例心脏骤停。结论:ECMO是肺移植的重要辅助工具。根据患者的氧合和循环状况,准确评估患者心肺功能,采用ECMO,可为肺移植麻醉提供有效支持。©2021,武汉大学医学杂志编辑委员会。版权所有。
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引用次数: 0
Nursing practice of extracorporeal membrane oxygenation combined with continuous renal replacement therapy in a severe COVID-19 patient with lung transplant 体外膜氧合联合持续肾替代治疗重症COVID-19肺移植患者的护理实践
Q4 Medicine Pub Date : 1900-01-01 DOI: 10.14188/j.1671⁃8852.2021.6004
S. Wang, L. Zhan, T. Fang, H. Gao, F. Xiong, X. Tang
Objective: To summarize the nursing path of extracorporeal membrane oxygenation (ECMO) combined with continuous renal replacement therapy (CRRT) after lung transplantation for severe COVID-19, and to provide clinical references for improving the specialized nursing process and strengthening the specialized nursing technology. Methods: We retrospectively analyzed a case of severe COVID-19 who received lung transplantation in Renmin Hospital of Wuhan University. Results: In this case, the cumulative duration of ECMO treatment was up to 64 days, in which ECMO combined with CRRT was used to treat acute kidney injury and dehydration after lung transplantation for 3 days, and ECMO and CRRT treatment was successfully withdrawn without embolism, infection, and other complications. Conclusion: Active nursing practices of monitoring on ECMO and CRRT procedures are vital for the success of lung transplantation. © 2021, Editorial Board of Medical Journal of Wuhan University. All right reserved.
目的:总结重症COVID-19肺移植术后体外膜氧合(ECMO)联合持续肾替代治疗(CRRT)的护理路径,为改进专科护理流程、加强专科护理技术提供临床参考。方法:回顾性分析武汉大学人民医院收治的1例重症COVID-19患者肺移植手术。结果:本病例ECMO治疗累计时间达64天,其中ECMO联合CRRT治疗肺移植术后急性肾损伤及脱水3天,ECMO联合CRRT治疗成功退出,无栓塞、感染等并发症。结论:积极的ECMO和CRRT监测护理对肺移植手术的成功至关重要。©2021,武汉大学医学杂志编辑委员会。版权所有。
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引用次数: 0
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武汉大学学报(医学版)
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