中国体外生命支持2026，Vol.24Issue(4)：355-360,6.DOI:10.13498/j.cnki.chin.j.ecls.2026.04.15
体外膜氧合患者气道出血危险因素及护理的研究进展
Research Progress on Risk Factors and Nursing Care of Airway Hemorrhage in Patients Undergoing Extracorporeal Membrane Oxygenation
马锦华 1胡雪慧 1罗建超 2程乔 1赵荣2
作者信息
- 1. 空军军医大学第一附属医院护理部,西安 710032
- 2. 空军军医大学第一附属医院心血管外科监护室,西安 710032
- 折叠
摘要
Abstract
Extracorporeal membrane oxygenation(ECMO)is a critical life-saving technique for severe cardiopulmonary failure;however,bleeding complications,particularly airway hemorrhage,pose a significant threat to patient survival.The core argument of this article is that ECMO-associated airway hemorrhage is essentially a multifactorial iatrogenic injury occurring in a fragile vascular state.Its pathogenesis involves three interrelated pathways:the interplay between anticoagulation and acquired coagulopathy(such as acquired von Willebrand syndrome),disruption of vascular endothelial integrity caused by systemic inflammatory response syndrome(SIRS),and physical triggering by iatrogenic interventions such as mechanical ventilation.Risk factors span multiple dimensions,including anticoagulation management deficiencies,underlying patient comorbidities,inappropriate ventilator settings,and device-related characteristics.The key to prevention and management lies in establishing a risk assessment-based integrated strategy,encompassing precise anticoagulation guided by multimodal monitoring,ultra-protective lung ventilation,structured nursing care incorporating human factors engineering,and a graded emergency response system for bleeding events.Future research should focus on developing individualized risk prediction models,investigating novel biocompatible materials,and further quantifying and standardizing nursing protocols to reduce the incidence of airway hemorrhage and improve patient outcomes.关键词
体外膜氧合/气道出血/危险因素/全身炎症反应综合征/抗凝管理/护理Key words
extracorporeal membrane oxygenation/airway hemorrhage/risk factors/systemic inflammatory response syndrome/anticoagulation management/nursing care引用本文复制引用
马锦华,胡雪慧,罗建超,程乔,赵荣..体外膜氧合患者气道出血危险因素及护理的研究进展[J].中国体外生命支持,2026,24(4):355-360,6.
