体外膜肺氧合期间抗凝管理

Management of anticoagulation during extracorporeal membrane oxygenation

近年来,随着急危重症医学专业诊疗理念与技术不断革新,体外生命支持技术得以临床应用与推广,体外膜肺氧合(extracorporealmembraneoxygenation,ECMO)越来越多应用于临床急危重症患者,被称为心肺衰竭患者生命的“最后一道防线”。随着生物科学技术及医疗水平的进步,虽然ECMO辅助心肺衰竭患者的整体救治成功率显著提高,但在ECMO治疗期间,出血或血栓等凝血系统相关并发症仍然是导致高死亡率的主要因素之一,ECMO支持期间凝血系统特点、并发症、药物选择、抗凝监测策略的规范化学习与管理需引起临床医务人员的重视。

In recent years,with the progress of critical medical diagnosis and treatment concept and technology,extracorporeal life support(ECLS)technology has been popularized.Extracorporeal membrane oxygenation(ECMO)is increasingly used in clinical acute and critically ill patients,which is called the"last line of defense"of patients with heart and lung failure.With the progress of biological science and technology and medical level,the survival rate of patients with ECMO assisted cardiopulmonary failure is improved,and the complications are gradually reduced.However,during ECMO treatment,coagulation-related complications such as bleeding or thrombus are one of the main factors leading to high mortality.The standardized learning and management of coagulation system characteristics,complications,drug selection,and anticoagulant monitoring strategies during ECMO support need to attract the attention of clinical medical staff.