2025 年第 8 期 第 20 卷

急性呼吸窘迫综合征体外膜氧合辅助呼吸治疗研究进展

Research progress on extracorporeal membrane oxygenation assisted respiratory therapy for acute respiratory distress syndrome

作者：谢雅欣符鸿福王红

英文作者：Xie Yaxin Fu Hongfu Wang Hong

单位：首都医科大学附属北京安贞医院心脏外科危重症中心北京市心肺血管疾病研究所，北京100029

英文单位：Center for Cardiac Surgery Critical Care Beijing Anzhen Hospital Capital Medical University Beijing Institute of Heart Lung and Blood Vessel Diseases Beijing 100029 China

关键词：急性呼吸窘迫综合征；体外膜氧合；肺保护性通气

英文关键词：Acuterespiratorydistresssyndrome;Extracorporealmembraneoxygenation;Lungprotectiveventilation

• 摘要：

• 对于重度急性呼吸窘迫综合征(ARDS)患者，静脉-静脉体外膜氧合（VV-ECMO）可以引流静脉系统的血液通过气体交换装置后再返回静脉系统，从而促进患者氧合和二氧化碳清除，并且使得自然肺在此期间实现“肺休息”。但在重度ARDS治疗过程中VV-ECMO期间呼吸机最佳设置的问题仍缺乏统一认识。近年来，肺保护性通气普遍应用，俯卧位通气、吸入一氧化氮也可作为治疗ARDS患者的选择。本综述旨在描述VV-ECMO在ARDS患者中的应用及通气策略。

• For patients with severe acute respiratory distress syndrome (ARDS), veno-venous extracorporeal membrane oxygenation (VV-ECMO) can drain blood from the venous system through a gas exchange device and then return to the venous system, thereby promoting oxygenation and carbon dioxide removal in ARDS patients, and allowing the natural lung to achieve "lung rest" during this period. However, there is still a lack of consensus on the optimal ventilator setting during VV-ECMO in the treatment of severe ARDS. In recent years, lung protective ventilation has been widely used, and prone position ventilation and inhaled nitric oxide can also be used as options for the treatment of ARDS patients. The purpose of this review is to describe the application of VV-ECMO in ARDS patients and the ventilation strategy.