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Extracorporeal Membrane Oxygenation and Lung Transplantation: Initial Experience at a Single Brazilian Center.

体外膜肺氧合和肺移植: 巴西单一中心的初步经验。

  • 影响因子:1.35
  • DOI:10.6061/clinics/2020/e1698
  • 作者列表:"Pola-Dos-Reis F","Samano MN","Abdalla LG","Carvalho GVS","Fernandes LM","Gomes-Júnior O","Carraro RM","Camargo PCLB","Teixeira RHOB","Afonso-Júnior JE","Pêgo-Fernandes PM
  • 发表时间:2020-04-30
Abstract

OBJECTIVE:To report initial experience from the use of extracorporeal membrane oxygenation (ECMO) in patients who received lung transplantation. METHODS:Retrospective study of a single tertiary center in the Brazilian state of São Paulo, a national reference in lung transplantation, based on the prospective collection of data from electronic medical records. The period analyzed extended from January 2009 (beginning of the program) until December 2018. RESULTS:A total of 75 lung transplants were performed, with ECMO used in 8 (10.7%) cases. Of the patients, 4 (50%) were female. The mean age was 46.4±14.3 years. The causes of the end-stage lung disease that led to transplantation were pulmonary arterial hypertension in 3 (37.5%) patients, bronchiectasis in 2 (25%) patients, pulmonary fibrosis in 2 (25%) patients, and pulmonary emphysema in 1 (12.5%) patient. In our series, 7 (87.5%) cases were sequential bilateral transplantations. Prioritization was necessary in 4 (50%) patients, and in 1 patient, ECMO was used as a bridge to transplantation. The ECMO route was central in 4 (50%), peripheral venovenous in 2 (25%) and peripheral venoarterial in 2 (25%) patients. The mean length of the intensive care unit (ICU) stay was 14±7.5 days and of the hospital stay was 34.1±34.2 days. The mean ECMO duration was 9.3±6.6 days with a 50% decannulation rate. Three patients were discharged (37.5%). CONCLUSION:Lung transplantation requires complex treatment, and ECMO has allowed extending the indications for transplantation and provided adjuvant support in the clinical management of these patients.

摘要

目的: 报告肺移植患者使用体外膜肺氧合 (ECMO) 的初步经验。 方法: 对巴西圣保罗州的一个单一三级中心进行回顾性研究,该中心是肺移植的国家参考,基于对电子病历数据的前瞻性收集。分析的时间从2009年1月 (计划开始) 延长至2018年12月。 结果: 共完成75例肺移植,8例 (10.7%) 使用ECMO。患者中,4例 (50%) 为女性。平均年龄为46.4 ± 14.3岁。导致移植的终末期肺病的原因是3例 (37.5%) 患者的肺动脉高压,2例 (25%) 患者的支气管扩张,2例 (25%) 患者的肺纤维化和1例 (12.5%) 患者的肺气肿。在我们的系列研究中,7例 (87.5%) 是双侧连续移植。4例 (50%) 患者需要优先排序,1例患者使用ECMO作为移植的桥梁。4例 (50%) 患者的ECMO途径为中枢,2例 (25%) 患者的外周静脉为外周静脉,2例 (25%) 患者的外周静脉为外周静脉。重症监护病房 (ICU) 的平均住院时间为14 ± 7.5天,住院时间为34.1 ± 34.2天。平均ECMO持续时间为9.3 ± 6.6天,拔管率为50%。3例患者出院 (37.5%)。 结论: 肺移植需要复杂的治疗,ECMO允许延长移植的适应症,并在这些患者的临床管理中提供辅助支持。

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影响因子:1.16
发表时间:2020-01-01
DOI:10.1080/19338244.2019.1606774
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影响因子:2.66
发表时间:2020-01-01
DOI:10.1016/j.alit.2019.05.012
作者列表:["Sunadome H","Matsumoto H","Izuhara Y","Nagasaki T","Kanemitsu Y","Ishiyama Y","Morimoto C","Oguma T","Ito I","Murase K","Muro S","Kawaguchi T","Tabara Y","Chin K","Matsuda F","Hirai T"]

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支气管疾病方向

支气管疾病包括支气管哮喘、支气管肿瘤、支气管炎、支气管扩张、支气管痉挛、支气管囊肿等疾病。

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