The application of ECMO in the treatment of severe pregnant women

doi:10.3877/cma.j.issn.2095-3259.2022.02.004

Abstract

Abstract:

Extracorporeal membrane oxygenation (ECMO) is more widely used in critically ill patients, which has gained time for the recovery of cardiopulmonary function. The ECMO technology has undergone dramatic changes. New small-diameter catheters have simplified vascular access, and the application of long-lasting anticoagulant coatings has improved the ECMO system′s histocompatibility, reduced blood damage, and reduced inflammation and thrombosis. ECMO has become simpler and safer. Because some serious pregnancy and delivery complications may lead to heart or lung failure, the use of ECMO during the perinatal period has also increased. In this paper, the indications, complications and matters needing attention of ECMO during perinatal severe illnesses were discussed.

Key words: Extracorporeal membrane oxygenation (ECMO), Critical care, Pregnancy complications, Heart failure, Respiratory insufficiency

Xiaona Wang, Guiqin Bai. The application of ECMO in the treatment of severe pregnant women[J]. Chinese Journal of Obstetric Emergency(Electronic Edition), 2022, 11(02): 81-87.

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References 62

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VV-ECMO
	1.严重(但可逆的)呼吸衰竭
	2.高碳酸血症伴严重呼吸性酸中毒，尽管使用最佳的常规机械通气，呼吸频率增加到35次/min
	3.早期使用肌松剂治疗ARDS、俯卧位通气和适当的PEEP处理后，PaO₂/FiO₂<100，伴有FiO₂≥0.9及PEEP≥10 cmH₂O
VA-ECMO
	1.围产期心肌病、心肌梗死、心肌炎引起的顽固性左心室衰竭
	2.疑似羊水栓塞患者的顽固性右心或左心衰竭
	3.大面积肺动脉栓塞伴顽固性右心室衰竭
	4.需要长时间心肺复苏(至少10 min)，并有可能出现可逆的情况

VV-ECMO
	1.严重(但可逆的)呼吸衰竭
	2.高碳酸血症伴严重呼吸性酸中毒，尽管使用最佳的常规机械通气，呼吸频率增加到35次/min
	3.早期使用肌松剂治疗ARDS、俯卧位通气和适当的PEEP处理后，PaO₂/FiO₂<100，伴有FiO₂≥0.9及PEEP≥10 cmH₂O
VA-ECMO
	1.围产期心肌病、心肌梗死、心肌炎引起的顽固性左心室衰竭
	2.疑似羊水栓塞患者的顽固性右心或左心衰竭
	3.大面积肺动脉栓塞伴顽固性右心室衰竭
	4.需要长时间心肺复苏(至少10 min)，并有可能出现可逆的情况

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