引用本文:项 龙,任 宏.儿童体外膜肺氧合出血和血栓并发症管理的新进展[J].中国临床新医学,2023,16(7):667-672.
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儿童体外膜肺氧合出血和血栓并发症管理的新进展
项 龙,任 宏
200127 上海,上海交通大学医学院附属上海儿童医学中心重症医学科
摘要:
[摘要] 体外膜肺氧合(ECMO)是救治儿童心肺衰竭的重要手段。出血和血栓并发症是ECMO支持期间患儿死亡的主要原因。目前,缺乏关于儿童ECMO期间抗凝、出血及其监测管理的具体指南和建议。该文对近年来儿童ECMO出血和血栓并发症管理的新进展进行综述,包括发生机制、儿童自身相关危险因素、临床监测以及管理等方面,以提供相关诊治的新思路。
关键词:  体外膜肺氧合  出血  血栓形成  抗凝  儿童
DOI:10.3969/j.issn.1674-3806.2023.07.06
分类号:R 72
基金项目:国家重点研发计划项目(编号:2021YFC2701800);上海市卫生健康委员会临床研究专项课题(编号:202040338)
Recent advances in the management of hemorrhage and thrombotic complications in pediatric extracorporeal membrane oxygenation therapy
XIANG Long, REN Hong
Department of Critical Care Medicine, Shanghai Children′s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
Abstract:
[Abstract] Extracorporeal membrane oxygenation(ECMO) is an important therapy method to treat cardiopulmonary failure in children. Hemorrhage and thrombotic complications are the main causes for the dead patients during ECMO support. At present, there is a lack of specific guidelines and recommendations on anticoagulation, hemorrhage and their monitoring and management during ECMO in children. This paper reviews the recent advances in the management of hemorrhage and thrombotic complications in children with ECMO in recent years, including the pathogenesis, related risk factors for children themselves, clinical monitoring and management, in order to provide new ideas for related diagnosis and treatment.
Key words:  Extracorporeal membrane oxygenation(ECMO)  Hemorrhage  Thrombosis  Anticoagulation  Children