Application value of ultrasound in the veno-venous extracorporeal membrane oxygenation stage in acute respiratory distress syndrome

SONG Yan; GUO Fengwei; BAI Xiaofang; CHEN Hong; DONG Yaling; SHANG Jia’nan; LIU Miaomiao; ZHANG Ying; SHI Tao; YAN Yang; RUAN Litao

doi:10.16245/j.cnki.issn1008-6978.2021.01.025

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Application value of ultrasound in the veno-venous extracorporeal membrane oxygenation stage in acute respiratory distress syndrome

更新时间：2021-10-13

- Application value of ultrasound in the veno-venous extracorporeal membrane oxygenation stage in acute respiratory distress syndrome
- Journal of Clinical Ultrasound in Medicine Vol. 23, Issue 1, Pages: 73-76(2021)
- 作者机构：
  
  1. 西安交通大学第一附属医院超声医学科
  2. 西安交通大学第一附属医院心血管外科
- 作者简介：
- 基金信息：
- DOI：10.16245/j.cnki.issn1008-6978.2021.01.025
  CLC： R445.1;R563.8
- Published：2021，
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[1]宋艳,郭锋伟,白晓芳,陈红,董亚玲,尚佳楠,刘淼淼,张颖,师桃,闫炀,阮骊韬.超声在急性呼吸窘迫综合征围静脉-静脉体外膜氧合期中的应用价值[J].临床超声医学杂志,2021,23(01):73-76.

SONG Yan, GUO Fengwei, BAI Xiaofang, et al. Application value of ultrasound in the veno-venous extracorporeal membrane oxygenation stage in acute respiratory distress syndrome. [J]. Journal of Clinical Ultrasound in Medicine 23(1):73-76(2021)
[1]宋艳,郭锋伟,白晓芳,陈红,董亚玲,尚佳楠,刘淼淼,张颖,师桃,闫炀,阮骊韬.超声在急性呼吸窘迫综合征围静脉-静脉体外膜氧合期中的应用价值[J].临床超声医学杂志,2021,23(01):73-76. DOI： 10.16245/j.cnki.issn1008-6978.2021.01.025.

SONG Yan, GUO Fengwei, BAI Xiaofang, et al. Application value of ultrasound in the veno-venous extracorporeal membrane oxygenation stage in acute respiratory distress syndrome. [J]. Journal of Clinical Ultrasound in Medicine 23(1):73-76(2021) DOI： 10.16245/j.cnki.issn1008-6978.2021.01.025.

摘要

目的探讨经胸超声心动图、血管超声及腹部超声在急性呼吸窘迫综合征（ARDS）患者围静脉-静脉体外膜氧合（V-V ECMO）期的临床应用价值。方法选取我院拟行V-V ECMO支持治疗的ARDS患者13例

分析超声在插管前对患者基本情况的评估结果

以及在插管过程中、V-V ECMO支持治疗期间和脱机后对心脏及血管相关并发症监测情况。结果行V-V ECMO支持治疗的13例ARDS患者中

12例存活至脱机

8例存活至康复出院。V-V ECMO插管过程中

7例在超声引导下调整套管末端位置;V-V ECMO支持治疗期间

2例在超声引导下调整套管末端位置。并发症发生情况:V-V ECMO支持治疗期间血管超声提示2例套管周围血栓形成

腹部超声提示1例腹腔出血;脱机后超声心动图提示1例下腔静脉附壁血栓形成

血管超声提示1例插管同侧下肢深静脉血栓形成。围V-V ECMO期无严重不良事件发生。结论超声在V-V ECMO插管过程中、支持治疗期间及监测并发症方面均具有重要价值。

Abstract

ObjectiveTo explore the application value of transthoracic echocardiography

vascular ultrasound andabdominal ultrasound in patients with acute respiratory distress syndrome（ARDS）in the veno-venous extracorporeal membraneoxygenation（V-V ECMO）stage.MethodsThirteen patients with ARDS who were proposed to be treated with V-V ECMOsupport in our hospital were selected.To summarize and analyze the results of patients’ basic condition by echocardiography

vascular ultrasound and abdominal ultrasound before intubation were summarize and analyze

as well as the monitoring of cardiacand vascular complications during intubation

during ECMO supportive treatment and after weaning.ResultsOf the 13 patientswith ARDS treated with V-V ECMO support

12 survived to offline and 8 survived to recovery and discharge.During ECMOassisted and supportive treatment

7 cases needed ultrasonic guidance to adjust the position of the cannula end.During ECMOsupportive treatment

ultrasonic guided cannula end position was required in 2 cases.Occurrence of complications: during ECMOsupportive treatment

2 cases of vascular ultrasound indicated thrombus formation around the cannula

and 1 case was abdominalhemorrhage.After weaning-off

echocardiography indicated that mural thrombus of inferior vena cava in 1 case and deep veinthrombosis of ipsilateral lower extremities in 1 case. No adverse events occurred during the V-V ECMO period.ConclusionUltrasound plays an important role in V-V ECMO intubation

during adjuvant and supportive treatment

and inthe early detection of complications.

关键词

超声检查体外生命支持静脉-静脉体外膜氧合急性呼吸窘迫综合征

Keywords

UltrasonographyExtracorporeal life supportVeno-venous extracorporeal membrane oxygenationAcute respiratory distress syndrome

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