不同情况下成人ECMO临床应用专家共识

1052中国循环杂志2020年11月第35卷第11期总第269期Chinese Circulation Joumal,November,2020.Val.35a.11(Serial No.269）指南与共识不同情况下成人体外膜肺氧合临床应用专家共识（(2020版)中国心胸血管麻醉学会，中华医学会麻醉学分会，中国医师协会麻醉学医师分会，中华医学会呼吸病学分会，中华医学会重症医学分会摘要体外膜肺氧合(ECM0)临床上主要用于心脏功能不全和（或）呼吸功能不全的支持，是治疗难以控制的严重心力衰竭和呼吸衰竭的关键技术。随着ECMO的跨学科应用，治疗领域不同，涉及的各专业临床医护人员掌握ECMO的水平差异较大；现有的ECM0相关研究主要以回顾性队列研究和病例报道为主。本共识由中国心胸血管麻醉学会牵头组织多学科专家，参考国内外相关疾病诊疗专家共识和指南的基础上，结合我国ECMO临床实践，对ECMO应用流程和管理，ECMO的心脏外科应用，救治暴发性心肌炎、心脏骤停、心肌梗死、急性呼吸窘迫综合征、肺移植，以及CMO期间的镇静、镇痛管理等方面进行综合制定，供国内相关从业人员参考。关键词体外膜肺氧合：心力衰竭：呼吸衰竭：镇静：镇痛Expert Consensus on the Clinical Application of Adult Extracorporeal Membrane Oxygenation UnderDifferent Conditions (2020 Edition)Chinese Society of Cardiothoracic and Vascular Anesthesiology,Chinese Society of Anesthesiology,Chinese Association ofAnesthesiologists.Chinese Thoracic Society.Chinese Society of Critical Care Medicine.Corresponding Author:MIN Su,Email:ms89011068@163.comAbstractExtracorporeal membrane oxygenation (ECMO)is a key technology for the treatment of severe heart failure andrespiratory failure that are difficult to control with conventional strategies.With the interdiscipl inary application of ECMO andthe use in different treatment fields,the level of ECMO mastery among the involved professional clinical medical staffs variesgreatly;the existing ECMO-related studies mainly focus on retrospective cohort studies and case reports.This consensus isinitiated by the Chinese Society of Cardiothoracic and Vascular Anesthesiology,discussed and written by multidisciplinarydomestic experts,consensus experts referred relevant domestic and foreign consensus and guidelines,summarized experienceof domestic ECMO clinical practice,the application process and management of ECMO,the application of ECMO in cardiacsurgery,and the treatment of outbreaks comprehensive fommulations for myocarditis,cardiac arrest,myocardial infarction,acute respiratory distress syndrome,lung transplantation,and management of sedation and analgesia during ECMO.We hopethis consensus would be helpful as a reference tool for relevant domestic ECMO practitioners.Key words extracorporeal membraneoxygenation;heart failure;respiratory failure;sedation;analgesia(Chinese Circulation Journal,2020,35:1052.)体外膜肺氧合(ECMO)作为一种重要的体外生和演变，现今ECMO的适应证更加广泛，已在心脏命支持技术，临床上主要用于心脏功能不全和（或）外科手术、暴发性心肌炎、心肌梗死、心脏骤停、呼吸功能不全的支持，目前已经成为治疗难以控制急性呼吸窘迫综合征(ARDS)以及心肺器官移植等的严重心力衰竭和呼吸衰竭的关键技术1-。20世多个领域开展，并取得了一定的效果。近年来国纪60年代ECM0于国外开始应用于临床，20世纪内外已经相继发布了ECMO技术方面和单项疾病应末国内临床上成功开展ECMO。随着ECMO的发展用的专家共识和指南B-。然而随者ECMO的跨学通信作者：闵苏Emi止m89011068@163m中图分类号：R54文献标识码：C文章编号：1000-3614(2020)11-1052-12D0L1039%9i=n1000-3614.202011.002