ECMO, full name, extracorporal membrane oxygenization, Chinese-named exterior pulmonary oxidation: The essence of this is an improved artificial CPR machine, the core parts being the membrane (artificial lung) and blood pump (artificial heart), which are used to partially or completely replace the patient ‘ s CPR function and allow it to rest adequately, thus allowing time for treatment of the original disease. This technology, which emerged in the 1950s and was widely carried out abroad in the 1990s, started later in the country, with the previous period being applied mainly in the field of heart disease, and in the field of respiratory failure, which originated from the concentration of the new H1N1 influenza in 2009 in the country. Especially after 2020, the ECMO played a significant role in the rescue of the new coronary seriously ill, building the last lifeline.
i. ECMO works: It uses catheters and pumps to remove blood from the patient, remove CO2 and add oxygen to the gas exchange. Aerobic blood is then pumped back to the patient ‘ s circulatory system, which maintains the body ‘ s body ‘ s tissue oxidation and helps patients whose heart rate is stopped or who are not breathing to survive the dangerous period of the disease. The ECMOs are divided into VVs and VAs, depending on how the blood is sent back.
1. Lung replacement: V-V model: Estimation of intravenous blood from an oxidizer oxygen combined to remove CO2 and pump it into another vein. It is usually the choice of a femoral vein that is derived, an inner vein pumped into the neck, or a diaphragm that can be selected depending on the patient ‘ s condition. The principle is to exchange some of the gas before passing through the lungs to compensate for the failure of the lungs.
2. Cardiopulmonary replacement: V-A model: Estimation of intravenous blood from an oxidizer oxygen combined with CO2 removal pumped into the artery. It is usually chosen that the femoral vein is derived, that the femoral artery is pumped in, bypassing the heart and lungs, and that the V-A flow is a connection that supports the CPR function at the same time.
II. Under what circumstances the use of ECMO could be considered
The application of ECMO is very broad, including but not limited to:
1. Cardio-pulmonary failure: ECMO can be used as a temporary alternative to treatment when there is a serious problem with the patient ‘ s CPR function and can buy more time for treatment. Through the use of ECMOs, medical teams can effectively help patients to survive CPR and buy time for further treatment.
2. Severe lung infections: If a patient suffers from serious lung infections, such as pneumonia, pulmonary sepsis, etc., ECMO can help the patient through the infection period and support the recovery of lung function. In the case of severe lung infections, ECMO can reduce the lung burden and promote control of infection and restoration of lung function.
3. Acute respiratory distress syndrome: ECMO can be used for the treatment of acute respiratory distress syndrome to support the recovery of the patient ‘ s lung function. Acute respiratory distress syndrome (SARS) is an emergency, and the timely application of ECMO can avoid respiratory failure and increase treatment opportunities for patients.
4. Cardiac surgery: Before or after the heart operation, ECMO can be used as a means of supporting treatment to support the patient ‘ s CPR. During the heart operation, ECMO can assist in the recovery of the heart, reduce the burden on the heart and facilitate the recovery of the heart function.
III. Who is not fit to use ECMO
1. Patients with a significant hemorrhage tendency;
2. Late malignant tumours;
3. Serious damage to the central nervous system;
4. Irreversible or no appropriate treatment.
IV. What are the common complications of ECMO?
1. Haemorrhage: most of the haemorrhages are found in the piercings, and a few in the digestive tracts are haemorrhaging, soluble, which may be related to the destruction of the slabs, coagulation factors;
2. All types of infection;
Renal failure: more than 50 per cent of patients have had kidney failure, some of whom have recovered after short-term blood purification treatment;
Breemosis formation: due to the need for an intubation in the blood vessels and the inactivity of the bed during treatment supported by the ECMO, haemorrhage can be caused if the whole body is not coagulated. The most common is the formation of a deep entanglement of the lower limb, which, in serious cases, can even lead to a risk of pulmonary embolism.
Summary
The ECMO is currently the central support tool for severe CPR failure and is also known as the “life-saving device” for people with acute illnesses, a top life support technology. It is a technology that represents the level of emergency care in a hospital, a region, and even a country. The ECMO is increasingly being developed, and it is hoped that more people will understand the basic knowledge and importance of the ECMO, thus saving more lives.
He’s in shock.
