中国体外生命支持2025，Vol.23Issue(5)：441-448,456,9.DOI:10.13498/j.cnki.chin.j.ecls.2025.05.13
体外生命支持启用影响因素的研究进展
Research Advances in the Timing of Initiation for Extracorporeal Life Support
摘要
Abstract
Extracorporeal life support(ECLS),particularly extracorporeal membrane oxygenation(ECMO),is a critical intervention for severe cardiopulmonary failure,with its clinical efficacy highly dependent on the precision of initiation tim-ing.This article systematically reviews the influencing factors and recent advancements in determining the optimal timing for ECMO initiation,focusing on patient age,indications,contraindications,underlying comorbidities,and their associations with clinical outcomes.Evidence indicates that advanced age(>70 years),diabetes,chronic kidney disease,and other comorbidities significantly increase the risk of complications.Key indications include refractory respiratory failure(e.g.,PaO2/FiO2<50 mmHg persisting>3 hours)and cardiogenic shock(e.g.,cardiac index<2.2 L/(min·m²)),contingent upon strict exclusion of absolute contraindications such as irreversible neurological injury or advanced malignancies.Current guidelines emphasize integrating hemodynamic,metabolic,and oxygenation parameters for decision-making,yet global heterogeneity in initiation criteria per-sists,contributing to variable survival rates(29.5%-57.3%in adults).Future research should prioritize multicenter randomized controlled trials to validate dynamic risk assessment models and integrate artificial intelligence-driven strategies for personalized ECMO initiation,thereby advancing precision medicine in critical care.关键词
体外膜氧合/启用时机/急性呼吸窘迫综合征/心源性休克/危重病急救/预后因素Key words
extracorporeal membrane oxygenation/initiation timing/acute respiratory distress syndrome/cardiogenic shock/critical care medicine/prognostic factors引用本文复制引用
卢俊宇,李双磊..体外生命支持启用影响因素的研究进展[J].中国体外生命支持,2025,23(5):441-448,456,9.基金项目
国家重点研发计划(2021YFC2701700、2021YFC2701703) （2021YFC2701700、2021YFC2701703）
广西重点研发计划项目(桂科AB22080088) （桂科AB22080088）
中科协青年人才托举工程计划(2022QNRC001) （2022QNRC001）
北京市科技新星计划(20220484053) （20220484053）
