中国体外循环杂志2025，Vol.23Issue(4)：295-301,353,8.DOI:10.13498/j.cnki.chin.j.ecc.2025.04.03
清醒静脉-动脉体外膜氧合在心脏外科术后的应用
Application of awake veno-arterial extracorporeal membrane oxygenation in post-cardiac surgery:a single center retrospective cohort study
摘要
Abstract
Objective To investigate the optimal timing,prognostic benefits and influencing factors of awake extracorporeal membrane oxygenation(ECMO)in patients following cardiac surgery.Methods The clinical data of 56 patients with"awake ECMO"after cardiac surgery from January 2022 to June 2024 in Xijing Hospital were retrospectively analyzed.Patients were categorized into a fully awake group(no mechanical ventilation during ECMO)and a non-fully awake group(mechanical ventilation required during ECMO).The non-fully awake group was further stratified into an early awake subgroup(mechanical ventilation duration<40%of total ECMO support time)and a non-early awake subgroup(mechanical ventilation duration≥40%).The baseline data,extubation factors and clinical outcomes were compared between groups.Multivariate analysis was performed to identify predictors of early tracheal extubation in the non-fully awake group.Results The fully awake group exhibited significantly higher hospital survival rates compared to the non-fully awake group(P=0.04).The fully awake group also demonstrated shorter total mechanical ventilation time,reduced ICU stays,shorter hospitalization,and lower rates of major complications In the non-fully awake group,the early awake subgroup achieved higher survival rates and lower complication rates(P<0.001).Albumin and prealbumin significantly improved during awake ECMO compared to tracheal intubation(P<0.05).Multivariate analysis identified postoperative pulmonary complications and oxygenation index as independent predictors of successful awake ECMO implementation.Conclusion Early awake V-A ECMO in post-cardiac surgery patients is associated with improved survival,reduced complications,enhanced nutritional status,and shorter hospital stays.关键词
清醒/动脉-静脉/体外膜氧合/心脏外科手术/心源性休克Key words
Awake/Veno-arterial/Extracorporeal membrane oxygenation/Cardiac Surgery/Cardiogenic shock引用本文复制引用
罗建超,翟蒙恩,卢林鹤,吕向妮,刘金成,刘洋..清醒静脉-动脉体外膜氧合在心脏外科术后的应用[J].中国体外循环杂志,2025,23(4):295-301,353,8.基金项目
国家自然科学基金(82370273) （82370273）
国家重点研发计划(2023ZD0504400) （2023ZD0504400）
西京医院交叉项目(XJZT24JC37) （XJZT24JC37）
空军后勤自主科研项目(CKJ23WS2C008) （CKJ23WS2C008）
