重型新型冠状病毒肺炎肺移植患者应用体外膜肺氧合联合连续肾脏替代治疗的护理实践

Nursing practice of extracorporeal membrane oxygenation combined with continuous renal replacement therapy in a severe COVID-19 patient with lung transplant

目的:总结重型新型冠状病毒肺炎(COVID-19)肺移植患者应用体外膜肺氧合(ECMO)联合连续肾脏替代治疗(CRRT)的护理路径,为完善专科护理流程、强化专科护理技术提供临床借鉴。方法:回顾性分析武汉大学人民医院收治的1例重型COVID-19肺移植患者护理的过程。结果:患者ECMO治疗累计时间长达64 d,其中采用ECMO联合CRRT技术治疗肺移植术后急性肾损伤及脱水3 d,成功撤离ECMO及CRRT支持治疗,未发生栓塞、感染等其他并发症。结论:护士对ECMO联合CRRT的精心实践管控,为患者顺利的救治提供了保障,保证了患者顺利救治的成功率。

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acute kidney injury and dehydration after lung transplantation for 3 days, and ECMO and CRRT treatment was successfully withdrawn without embolism, infection,and other complications.Conclusion:Active nursing practices of monitoring on ECMO and CRRT procedures are vital for the success of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.