儿童体外膜氧合联合肾脏替代治疗研究进展

杨保旺 综述; 洪小杨 审校; 封志纯

doi:10.12372/jcp.2022.21e1326

临床儿科杂志 >

2022 , Vol. 40 >Issue 9: 710 - 714

DOI: https://doi.org/10.12372/jcp.2022.21e1326

文献综述

儿童体外膜氧合联合肾脏替代治疗研究进展

杨保旺综述 ,
洪小杨审校 ,
封志纯

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1.南方医科大学第二临床学院（广东广州 510000）
2.中国人民解放军总医院第七医学中心PICU（北京 100010）

收稿日期: 2021-09-13

网络出版日期: 2022-08-26

基金资助

首都卫生发展科研专项面上项目(首发2020-2-5093)

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Research progress of extracorporeal membrane oxygenation combined with renal replacement therapy in children

Baowang Reviewer: YANG ,
Xiaoyang Reviser: HONG ,
Zhichun FENG

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1. The Second Clinical College of South Medical University, Guangzhou 510000, Guangdong, China
2. Department of PICU, The 7th Medical Center of PLA General Hospital, Beijing 100010, China

Received date: 2021-09-13

Online published: 2022-08-26

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摘要

体外膜氧合（ECMO）技术作为严重心肺衰竭的挽救性治疗手段在儿童重症领域的应用越来越广泛,使用该技术虽然患儿生存率较前逐渐改善,但仍有急性肾损伤、全身感染、出血及血栓等严重并发症。急性肾损伤及液体过负荷的发生会明显增加ECMO患儿的死亡率及延长ECMO的运行时间,因此肾替代治疗越来越多地用于ECMO患者以进行容量过负荷和急性肾损伤的管理。文章对儿童ECMO联合肾脏替代治疗的策略进行综述,探讨儿童ECMO时急性肾损伤的发生率及高危因素、肾脏替代治疗时机、肾脏替代治疗的管理策略、预后及不同肾脏替代治疗策略的优缺点。

关键词： 体外膜氧合; 急性肾损伤; 肾替代治疗; 儿童

本文引用格式

杨保旺综述 , 洪小杨审校 , 封志纯 . 儿童体外膜氧合联合肾脏替代治疗研究进展[J]. 临床儿科杂志, 2022 , 40(9) : 710 -714 . DOI: 10.12372/jcp.2022.21e1326

Abstract

Extracorporeal membrane oxygenation (ECMO), as a salvage treatment for severe cardiopulmonary failure, has been widely applied in pediatric patients with severe diseases. Although the survival rate of children is gradually improved after the use of this technique, there are still some complications, such as acute kidney injury, systemic infection, hemorrhage and thrombosis. Studies have shown that acute kidney injury and fluid overload can significantly increase the mortality and prolong the running time of ECMO in children. Therefore, renal replacement therapy is increasingly used for the management of fluid overload and acute kidney injury in patients with ECMO. This article reviewed the strategies of ECMO combined with renal replacement therapy in children, and discussed the incidence and risk factors of acute kidney injury, timing of renal replacement therapy, management strategy of renal replacement therapy, prognosis, and advantages and disadvantages of different renal replacement therapy strategies.

Key words： extracorporeal membrane oxygenation; acute kidney injury; renal replacement therapy; child

参考文献

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