최소 단어 이상 선택하여야 합니다.
최대 10 단어까지만 선택 가능합니다.
다음과 같은 기능을 한번의 로그인으로 사용 할 수 있습니다.
NTIS 바로가기Tuberculosis and respiratory diseases : TRD = 결핵 및 호흡기 질환, v.72 no.1, 2012년, pp.1 - 7
김고운 (울산대학교 의과대학 서울아산병원 중환자의학 및 호흡기내과학교실) , 최은영 (영남대학교 의과대학 중환자의학 및 호흡기내과학교실) , 홍상범 (울산대학교 의과대학 서울아산병원 중환자의학 및 호흡기내과학교실)
Extracorporeal Membrane Oxygenation (ECMO) support to tissue oxygenation has been shown to improve survival in patients with life threatening respiratory distress syndrome or cardiac failure. Extracorporeal life support such as ECMO, including extracorporeal
* AI 자동 식별 결과로 적합하지 않은 문장이 있을 수 있으니, 이용에 유의하시기 바랍니다.
핵심어 | 질문 | 논문에서 추출한 답변 |
---|---|---|
호흡부전환자에서 인공환기기의 사용의 문제점은? | 호흡부전환자에서 인공환기기의 사용은 많은 환자의 생명을 구했으나, 인공환기기 자체에 의한 기계환기유발성 폐손상(ventilator-induced lung injury, VILI)을 야기할 수 있음이 알려졌다1. 이에 일회 환기량(tidal volume, TV) 6 mL/PBW, 고평부압(plateau pressure) 30 cm H2O, 산소 농도(FiO2) 60% 이하의 폐보호 환기법이 보편화되고 있다. | |
ECMO이란? | 이에 최근 체외순환을 이용한 veno-venous ECMO (high flow) 및 extracorporeal CO2 removal (ECCO2R, low flow)가 임상에 적용되고 있다. ECMO는 회복가능성이 있는 심각한 호흡부전이나 심부전 환자에서 고식적인 치료방법에 실패한 경우, 심폐기능이 회복될 때까지 수 일에서 수 주 동안 생명유지를 도와주는 체외순환의 일종이다. | |
iLA의 장점은? | ECMO에 비해 시술이 쉽고 도관에 헤파린이 도포되어 있어 저용량의 헤파린만 사용해도 되고 이산화탄소 제거가 용이하여 과환기에 의한 기계환기 유발 폐손상을 줄일 수 있다15. |
de Prost N, Ricard JD, Saumon G, Dreyfuss D. Ventilatorinducedlung injury: historical perspectives and clinicalimplications. Ann Intensive Care 2011;1:28.
Terragni PP, Rosboch G, Tealdi A, Corno E, MenaldoE, Davini O, et al. Tidal hyperinflation during low tidalvolume ventilation in acute respiratory distress syndrome.Am J Respir Crit Care Med 2007;175:160-6.
Peek GJ, Mugford M, Tiruvoipati R, Wilson A, Allen E,Thalanany MM, et al. Efficacy and economic assessmentof conventional ventilatory support versus extracorporealmembrane oxygenation for severe adultrespiratory failure (CESAR): a multicentre randomisedcontrolled trial. Lancet 2009;374:1351-63.
Higgins AM, Pettila V, Harris AH, Bailey M, Lipman J,Seppelt IM, et al. The critical care costs of the influenzaA/H1N1 2009 pandemic in Australia and New Zealand.Anaesth Intensive Care 2011;39:384-91.
Patroniti N, Zangrillo A, Pappalardo F, Peris A, CianchiG, Braschi A, et al. The Italian ECMO network experienceduring the 2009 influenza A(H1N1) pandemic:preparation for severe respiratory emergency out breaks. Intensive Care Med 2011;37:1447-57.
Choi H, Lee WG, Lee SM, Moon HS, Chung YK, LeeKH, et al. Prolonged extracorporeal lung heart assist(extracorporeal membrane oxygenation) - 4 cases report.Korean J Anesthesiol 1992;25:424-32.
Bartlett RH, Gazzaniga AB, Huxtable RF, Schippers HC,O'Connor MJ, Jefferies MR. Extracorporeal circulation(ECMO) in neonatal respiratory failure. J Thorac CardiovascSurg 1977;74:826-33.
Morioka T. Extracorporeal lung assist: ECLA. KyobuGeka 1989;42:766-7.
Gattinoni L, Pesenti A, Pelizzola A, Caspani ML,Iapichino G, Agostoni A, et al. Reversal of terminalacute respiratory failure by low frequency positivepressure ventilation with extracorporeal removal ofCO2 (LFPPV-ECCO2R). Trans Am Soc Artif InternOrgans 1981;27:289-93.
Marasco SF, Lukas G, McDonald M, McMillan J, IhleB. Review of ECMO (extra corporeal membrane oxygenation)support in critically ill adult patients. HeartLung Circ 2008;17 Suppl 4:S41-7.
Extracorporeal Life Support Organization [Homepage].Ann Arbor, MI: ELSO; c2011 [cited 2011 Nov 25].Available from: http://www.elso.med.umich.edu/Guidelines.html.
Zapol WM, Snider MT, Hill JD, Fallat RJ, Bartlett RH,Edmunds LH, et al. Extracorporeal membrane oxygenationin severe acute respiratory failure. A randomizedprospective study. JAMA 1979;242:2193-6.
Hemmila MR, Rowe SA, Boules TN, Miskulin J,McGillicuddy JW, Schuerer DJ, et al. Extracorporeal lifesupport for severe acute respiratory distress syndromein adults. Ann Surg 2004;240:595-605.
Lin TY, Horng FM, Chiu KM, Chu SH, Shieh JS. A simplemodification of inflow cannula to reduce recirculationof venovenous extracorporeal membraneoxygenation. J Thorac Cardiovasc Surg 2009;138:503-6.
Liebold A, Reng CM, Philipp A, Pfeifer M, BirnbaumDE. Pumpless extracorporeal lung assist - experiencewith the first 20 cases. Eur J Cardiothorac Surg 2000;17:608-13.
Reng M, Philipp A, Kaiser M, Pfeifer M, Gruene S,Schoelmerich J. Pumpless extracorporeal lung assistand adult respiratory distress syndrome. Lancet 2000;356:219-20.
Bein T, Weber F, Philipp A, Prasser C, Pfeifer M,Schmid FX, et al. A new pumpless extracorporeal interventionallung assist in critical hypoxemia/hypercapnia.Crit Care Med 2006;34:1372-7.
Zimmermann M, Bein T, Arlt M, Philipp A, RupprechtL, Mueller T, et al. Pumpless extracorporeal interventionallung assist in patients with acute respiratory distresssyndrome: a prospective pilot study. Crit Care2009;13:R10.
Chen YS, Lin JW, Yu HY, Ko WJ, Jerng JS, Chang WT,et al. Cardiopulmonary resuscitation with assisted extracorporeallife-support versus conventional cardiopulmonaryresuscitation in adults with in-hospital cardiacarrest: an observational study and propensity analysis.Lancet 2008;372:554-61.
Chen YS, Chao A, Yu HY, Ko WJ, Wu IH, Chen RJ,et al. Analysis and results of prolonged resuscitationin cardiac arrest patients rescued by extracorporealmembrane oxygenation. J Am Coll Cardiol 2003;41:197-203.
Cardarelli MG, Young AJ, Griffith B. Use of extracorporealmembrane oxygenation for adults in cardiacarrest (E-CPR): a meta-analysis of observational studies.ASAIO J 2009;55:581-6.
Thiagarajan RR, Brogan TV, Scheurer MA, Laussen PC,Rycus PT, Bratton SL. Extracorporeal membrane oxygenationto support cardiopulmonary resuscitation inadults. Ann Thorac Surg 2009;87:778-85.
Jackson A, Cropper J, Pye R, Junius F, Malouf M,Glanville A. Use of extracorporeal membrane oxygenationas a bridge to primary lung transplant: 3 consecutive,successful cases and a review of the literature.J Heart Lung Transplant 2008;27:348-52.
Olsson KM, Simon A, Strueber M, Hadem J, WiesnerO, Gottlieb J, et al. Extracorporeal membrane oxygenationin nonintubated patients as bridge to lung transplantation. Am J Transplant. 2010;10:2173-8.
Mangi AA, Mason DP, Yun JJ, Murthy SC, Pettersson GB. Bridge to lung transplantation using short-termambulatory extracorporeal membrane oxygenation. J Thorac Cardiovasc Surg 2010;140:713-5.
Bermudez CA, Rocha RV, Zaldonis D, Bhama JK,Crespo MM, Shigemura N, et al. Extracorporeal membraneoxygenation as a bridge to lung transplant: midtermoutcomes. Ann Thorac Surg 2011;92:1226-31.
Mason DP, Thuita L, Nowicki ER, Murthy SC, PetterssonGB, Blackstone EH. Should lung transplantation beperformed for patients on mechanical respiratory support?The US experience. J Thorac Cardiovasc Surg 2010;139:765-73.
Hammainen P, Schersten H, Lemstrom K, Riise GC,Kukkonen S, Sward K, et al. Usefulness of extracorporealmembrane oxygenation as a bridge to lung transplantation: a descriptive study. J Heart LungTransplant 2011;30:103-7.
Agati S, Ciccarello G, Fachile N, Scappatura RM, GrassoD, Salvo D, et al. DIDECMO: a new polymethylpenteneoxygenator for pediatric extracorporeal membraneoxygenation. ASAIO J 2006;52:509-12.
Toomasian JM, Schreiner RJ, Meyer DE, Schmidt ME,Hagan SE, Griffith GW, et al. A polymethylpentene fibergas exchanger for long-term extracorporeal lifesupport. ASAIO J 2005;51:390-7.
Rhee I, Kwon SU, Sung K, Cho SW, Gwon HC, LeeYT, et al. Experiences with emergency percutaneouscardiopulmonary support in in-hospital cardiac arrestor cardiogenic shock due to the ischemic heart disease.Korean J Thorac Cardiovasc Surg 2006;39:201-7.
Plotz FB, van Oeveren W, Bartlett RH, Wildevuur CR.Blood activation during neonatal extracorporeal lifesupport. J Thorac Cardiovasc Surg 1993;105:823-32.
Robinson TM, Kickler TS, Walker LK, Ness P, Bell W.Effect of extracorporeal membrane oxygenation on plateletsin newborns. Crit Care Med 1993;21:1029-34.
Thelin S, Bagge L, Hultman J, Borowiec J, Nilsson L,Thorelius J. Heparin-coated cardiopulmonary bypasscircuits reduce blood cell trauma. Experiments in thepig. Eur J Cardiothorac Surg 1991;5:486-91.
Videm V, Svennevig JL, Fosse E, Semb G, Osterud A,Mollnes TE. Reduced complement activation with heparin-coated oxygenator and tubings in coronary bypassoperations. J Thorac Cardiovasc Surg 1992;103:806-13.
Borowiec J, Thelin S, Bagge L, Nilsson L, Venge P,Hansson HE. Heparin-coated circuits reduce activationof granulocytes during cardiopulmonary bypass. Aclinical study. J Thorac Cardiovasc Surg 1992;104:642-7.
Glauber M, Szefner J, Senni M, Gamba A, Mamprin F,Fiocchi R, et al. Reduction of haemorrhagic complicationsduring mechanically assisted circulation with theuse of a multi-system anticoagulation protocol. Int JArtif Organs 1995;18:649-55.
van der Staak FH, de Haan AF, Geven WB, Festen C.Surgical repair of congenital diaphragmatic hernia duringextracorporeal membrane oxygenation: hemorrhagiccomplications and the effect of tranexamic acid.J Pediatr Surg 1997;32:594-9.
Fergusson DA, Hebert PC, Mazer CD, Fremes S,MacAdams C, Murkin JM, et al. A comparison of aprotininand lysine analogues in high-risk cardiac surgery.N Engl J Med 2008;358:2319-31.
Horwitz JR, Cofer BR, Warner BW, Cheu HW, Lally KP.A multicenter trial of 6-aminocaproic acid (Amicar) inthe prevention of bleeding in infants on ECMO. JPediatr Surg 1998;33:1610-3.
※ AI-Helper는 부적절한 답변을 할 수 있습니다.