背景:体外膜氧合(ECMO)是严重呼吸衰竭的最后一张王牌。ECMO的主要并发症是出血和血栓,两者都可能危及生命。在ECMO期间,大的血凝块会导致中央气道阻塞(CAO),由于窒息,应尽快清除CAO。然而,没有关于其频率和管理的全面报告。这项研究的目的是分享罕见和严重疾病的治疗经验,并提供有价值的见解。
方法:我们报告了3例因严重呼吸衰竭而接受ECMO治疗的患者。
方法:所有3例患者在ECMO期间由于大血凝块发生CAO。
方法:使用柔性支气管镜清除大血凝块,抓镊子,和所有3例患者的净检索设备。
结果:在所有3名患者中,ECMO期间多次清除大血凝块.患者的呼吸系统状况得到改善,他们最终脱离了ECMO。
结论:在ECMO期间由于大血凝块引起的CAO是罕见的。需要支气管镜清除的CAO的频率估计为约1.5%。当这种情况发生时,应尽快清除血凝块。网络检索设备是用于收集大血凝块的有用工具。
BACKGROUND: Extracorporeal membrane oxygenation (ECMO) is the last trump card for severe respiratory failure. The main complications of ECMO are bleeding and thrombosis, both of which can be life-threatening. Large blood clots can cause central airway obstruction (CAO) during ECMO, and CAO should be removed as soon as possible because of asphyxiation. However, there is no comprehensive
reports on its frequency and management. The purpose of this study is to share therapeutic experiences for rare and serious conditions and provide valuable insights.
METHODS: We report 3 patients placed on ECMO for severe respiratory failure.
METHODS: CAO due to large blood clots occurred during ECMO in all 3 patients.
METHODS: Large blood clots were removed using flexible bronchoscopy, grasping forceps, and net retrieval devices in all 3 patients.
RESULTS: In all 3 patients, large blood clots were removed multiple times during ECMO. The patients\' respiratory conditions improved and they were eventually weaned off the ECMO.
CONCLUSIONS: CAO due to large blood clots during ECMO is rare. The frequency of CAO requiring bronchoscopic removal was estimated to be approximately 1,5%. When this occurs, clots should be removed as soon as possible. Net retrieval devices are useful tools for the collection of large blood clots.