CAJ | 학술논문

目的探讨体外膜肺氧合(ECMO)治疗重症急性呼吸窘迫综合征(ARDS)期间的氧代谢、乳酸水平的变化与预后的关系.方法回顾性分析17例机械通气效果不佳、应用体外膜肺氧合治疗的急性呼吸窘迫综合征患者,以应用ECMO后30 d为观察终点,分为存活组和死亡组,统计分析治疗前后两组患者的氧代谢、血乳酸水平变化,分析各项指标与预后的关系.结果应用体外膜肺氧合后,患者氧代谢情况明显改善,10例患者治愈,7例死亡.两组患者应用ECMO后氧供、氧耗均明显增加,存活组患者的氧摄取率基本维持在正常水平,乳酸水平呈下降趋势.死亡组患者的氧摄取率明显提高,乳酸水平未见明显下降.结论体外膜肺氧合治疗重症急性呼吸窘迫综合征,氧摄取率维持在正常水平、乳酸水平逐渐下降提示预后良好.
목적 탐토체외막폐양합(ECMO)치료중증급성호흡군박종합정(ARDS)기간적양대사、유산수평적변화여예후적관계.방법 회고성분석17례궤계통기효과불가、응용체외막폐양합치료적급성호흡군박종합정환자,이응용ECMO후30 d위관찰종점,분위존활조화사망조,통계분석치료전후량조환자적양대사、혈유산수평변화,분석각항지표여예후적관계.결과 응용체외막폐양합후,환자양대사정황명현개선,10례환자치유,7례사망.량조환자응용ECMO후양공、양모균명현증가,존활조환자적양섭취솔기본유지재정상수평,유산수평정하강추세.사망조환자적양섭취솔명현제고,유산수평미견명현하강.결론 체외막폐양합치료중증급성호흡군박종합정,양섭취솔유지재정상수평、유산수평축점하강제시예후량호.
Objective To obtain oxygen metabolic parameters and lactic acid concentration in Acute Respiratory Distress Syndrome(ARDS) patients treated by Extracorporeal Membrane Oxygenation (ECMO) , and to evaluate relationship between these variables and prognosis. Methods 17 ARDS patients treated by ECMO after failure of conventional ventilation therapy, were analyzed retrospectively. All the patients were divided into survival group and non-survival group according to the situation in the 30th day after ECMO. The oxygen metabolic paraters,lactic acid concentration were calculated and measured. Results 10 patients survived,7 died.Oxygen delivery(DO2), Oxygen consumption (VO2)were improved after ECMO in both groups. Oxygen extraction rate (ERO2)was mantained within normal range, lactic acid concentration decreased in survival group. ERO2 was improved,lactic acid concentration did not decreased in non-survival guoup. Conclusion In critical ARDS patients treated by ECMO,ERO2 within noumal range and decreasing trend in lactic acid concentration predict good prognosis.