摘要
体外二氧化碳清除（ECCO2R）是一种体外生命支持技术，通过体外膜肺（“人工肺”）清除机体过多产生的二氧化碳（CO2），以降低患者通气需求和呼吸机支持水平。随着体外生命支持相关技术的改进和临床经验的增多，最近研究提示ECCO2R在多种重症场景中具有重要的潜在价值，但亟待大样本临床研究进一步规范其临床指征及其床旁管理。本文通过文献复习和笔者经验，综述了ECCO2R在急性呼吸窘迫综合征（ARDS）、慢性阻塞性肺疾病急性加重（AECOPD）、肺移植围术期和哮喘持续状态等重症应用场景中的应用价值，以期为ECCO2R在重症场景中的应用提供更多参考。
Abstract
Extracorporeal carbon dioxide removal (ECCO2R) is an extracorporeal life support technology, designed to remove excessive carbon dioxide generated by the body through extracorporeal membrane lung ("artificial lung"), thus reducing patients' ventilatory demand and ventilator support level. With the improvement of related extracorporeal life support technologies and the accumulation of clinical experience, recent studies have suggested that ECCO2R has important potential value in a variety of clinical scenarios. However, it is still imperative but it is urgent to further standardize its clinical indications and bedside management through large sample clinical studies. This article reviewed the application value of ECCO2R in severe application scenarios, such as acute respiratory distress syndrome (ARDS), acute exacerbation of chronic obstructive pulmonary disease (AECOPD), perioperative period of lung transplantation, and persistent status of asthma, so as to provide more reference for the application of ECCO2R in severe clinical scenarios.
基金项目
"十四五"国家重点研发计划课题(2022YFC2504401)
万方数据