耐心:延长体外膜氧合支持,包括全系统切换,结果良好。

Journal of Medical Cases Pub Date : 2022-10-01 Epub Date: 2022-10-31 DOI:10.14740/jmc3979
Mathias Schmandt, Christian Putensen, Tatjana Stiehl, Julia Wagenpfeil, Jens-Christian Schewe, Stefan Felix Ehrentraut
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摘要

尽管治疗取得了巨大进步,急性呼吸窘迫综合征(ARDS)仍然是一种死亡率很高的疾病(42-48%)。静脉-静脉体外膜氧合(VV-ECMO)通常被用作最后的治疗选择,这给治疗团队带来了复杂的问题,特别是长时间的ECMO支持。我们报告了一个有趣的病例,一位40岁的女性患者发展为流行性感冒肺炎导致ARDS,随后需要体外膜肺切除术。由于严重的凝血并发症,需要延长ECMO运行时间并多次更换过滤器。经过56天的ECMO治疗,患者成功断奶。幸运的是,在进一步的治疗过程中,实现了完全恢复和整合。本病例报告的一个显著特征是描述了一个完整的ECMO系统的变化和同一患者同时使用两个ECMO系统。此外,我们提供了使用世界卫生组织残疾评估表2.0测量的患者当前与健康相关的生活质量的数据。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Be Patient: Prolonged Extracorporeal Membrane Oxygenation Support Including Full System Switch With Favorable Outcome.

Despite tremendous advances in treatment, acute respiratory distress syndrome (ARDS) remains a disease with high mortality (42-48%). Veno-venous extracorporeal membrane oxygenation (VV-ECMO) is often used as a last treatment option, which poses complex problems for the treatment team, especially with prolonged ECMO support. We report an interesting case of a 40-year-old female patient who developed influenza pneumonia leading to ARDS and subsequently requiring ECMO. Due to severe clotting complications, a prolonged ECMO run time with numerous filter changes was required. After a total of 56 days of ECMO therapy, the patient was successfully weaned. Fortunately, further in the course of treatment, complete recovery with restitutio ad integrum was achieved. A distinguishing feature of this case report is the description of a complete ECMO system change and the concurrent use of two ECMO systems for the same patient. Additionally, we provide data on the patient's current health-related quality of life as measured using the World Health Organization Disability Assessment Schedule 2.0.

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