The Department of Severe Medicine of Yiyang Central Hospital has successfully carried out the first ECMO treatment in the city

Extracorporeal Membrane Oxygenation (ECMO) is currently the most advanced internal vitro life support technology in the world.

It mainly uses the in vitro equipment to replace the lung and heart function, provides continuous in vitro breathing and circulating assistance for patients with severe patients to maintain the patient's life, thereby winning time for disease cure or organ function recovery.

Because of its powerful ability, it is hailed as "the ultimate life -saving artifact", this technology represents the comprehensive treatment level of a hospital or even a region.

On September 6, the Department of Critical Medicine of Yiyang Central Hospital successfully carried out the first ECMO treatment in the city, marking that Yiyang Central Hospital has been proficient in the clinical technology of ECMO, filling the gap of the city's medical technology.

The last line of vitality

Recently, Aunt Xia, 41, was admitted to the hospital for facial wounds and multiple fractures on both lower limbs due to a car accident.

Due to the large amount of blood loss, and at the same time, it has traumatic blood loss shock. After emergency green channels, it is urgently entered the operating room. After the macroscopy and suture of the omnidirectional subordinate oral and maxillofacial sominomy, transfer to the severity medical department.

After the doctor Li Youfu was admitted, the relevant examination was immediately improved according to the patient's condition. It was found that the patient had a right upper pulmonary arterial embolism at the same time. After the treatment of vascular active drugs and the ventilation of mechanical ventilation, the patient's breathing and cycle were still extremely unstable. Essence

The ultrasonic monitoring data beside the bed show that Aunt Xia has serious heart function abnormalities and blood flow dynamic obstacles, and the comparators are filled with a weakened contraction function, the heart is not effective, and her life is in danger.

Director Li Guofeng immediately asked the Ministry of the Medical Department to quickly organize experts in the hospital. Experts unanimously gave suggestions: At present, only ECMO technology can bring a line of vitality to patients.

Get time with the god of death

After full communication, with the support of the family members, Zhuang Shuilong, deputy director of the Department of Critical Medical Division, led the ECMO team of the department to immediately treat the VA-ECMO for patients.

The ultrasound beside the bed was cautious and carefully evaluated. The doctor selected the patient's right femoral arteries and femoral veins separately. At the same time, in order to ensure the blood transport of the right lower limb, it also set up a remote pouring tube for the patient.

Under the beside bed, Nurse Zhang Shenghua led the nursing team to cooperate to complete a series of operations such as ECMO pipeline pre -charging and installation.

The entire operation process is tight and orderly, and the connection is smooth.

With the close cooperation of medical and nursing teams in intensive medical medicine, the ECMO machine runs in an orderly manner.

As the bright red blood that passed the lung oxygen returned to the patient, Aunt Xia's heart rate, respiratory, blood pressure and other life signs gradually stabilized, and the rescue work was initially successful.

Double Swords together showing magical powers

Because of the severe ischemia and hypoxia before, in addition to cardiopulmonary failure, Aunt Xia also quickly experienced the failure of organs such as liver and kidney.

In order to help Aunt Xia survive the difficulty, the next day, the medical team continued to have kidney replacement therapy (CRRT) for the patients at the same time.

ECMO combined with CRRT can be described as a double sword, let Aunt Xia's condition temporarily stabilize.

The greater challenge is still behind

However, the medical team understands that ECMO has successfully taken the plane, just the first step in the Long March.

Next, ECMO's management requirements are very fine, and there are many complications to prevent prevention, such as how to anticoagulant and anti -thrombosis, how to calm down and analgesics, how to effectively mechanical ventilation, how to prevent and control the hospital, how to prevent limb ischemia and necrosis, etc. Mowing

These difficulties need to be cleared, each step is crucial.

In order to ensure the safety of patients, the department has organized the backbone of the department with ECMO training experience to take turns on duty at the bed, and monitor the patient's life signs 24 hours a day.

For a moment, the ECMO machine continued, and they kept away, sticking to the last line of defense to save the life of the patient.

The hospital attaches great importance to the rescue work. On the afternoon of September 9, Hu Li, secretary of the hospital party committee of the hospital, and Zhou Jianjun, deputy dean, came to the intensive medical department on the 7th floor of the Surgery Building.

Secretary Hu Li fully affirmed the rescue work of all medical staff of the severe medical department and the proficiency of ECMO clinical technology, and encouraged all medical staff to continue to refine their medical level, standardize medical behavior, and benefit more patients. Essence

How to understand the technology of ECMO

ECMO is the abbreviation of vitamin lung oxygen. In short: It is cardiopulmonary alternative. It consists of an artificial membrane lung, an artificial pump, a water tank (adjustment temperature), and a set of intravenous pipelines.

The core part of this technology is the membrane lung (artificial lung) and blood pump (artificial heart). When ECMO is running, the blood is led from the vein, and the carbon dioxide is discharged through the lung oxygen of the membrane. The arterial blood and then flow into the human body under the drive of the centrifugal pump to achieve sufficient gas exchange and (or) heart assistance and the purpose of satisfying organs and tissue irrigation, so that the heart and lungs are fully resting Treatment time.

What are the two types of conventional ECMO technology

According to the path of blood transmission after the lung oxygen passes through the lung oxygen, it can be divided into two types of V-V (venous blood, venous recovery) and V-A turning (venous blood diversion, arterial blood):

V-V rotation: It is mainly used for in vitro respiratory function support. After intravenous veins, the vein is used to cause oxygen oxygen to remove carbon dioxide and pump into another vein.

Generally, the vein of the femoral vein is usually pumped in the neck vein, and bilateral femoral veins can also be selected according to the patient's condition.V-V rotation is suitable for cases of simply lung function damage and no risk of stopping the heart.V-A turning: it can be used for both in vitro breathing support and cardiac functional support. The blood pump can replace most of the heart pump blood function and maintain blood circulation.

V-A rotates veins from veins. After the oxygen oxygen is used to eliminate carbon dioxide, the arteries are pumped.

It is a treatment method that supports cardiopulmonary function at the same time, suitable for cardiac failure and (or) lung function failure or even heart stopping.

The ECMO method should be flexibly selected with the cause and condition.

Generally speaking, V-V turns into a lung alternative mode, and V-A is turned into cardiopulmonary combined alternative mode.

(Edit Rainbow.)

Special Author of Hunan Medical Chat: Li Youfu Tu/Zhu Wendai, Yiyang Central Hospital

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