Роль экстракорпоральной мембранной оксигенации в комплексном лечении острых химических отравлений

Цель. Анализ данных литературы по применению экстракорпоральной мембранной оксигенации (ЭКМО) при острых отравлениях химической этиологии.

Материал и методы. Поиск отечественных публикаций проводился в базе данных eLibrary, зарубежных — в базах MEDLINE/PubMed, Google Scholar за период 2010–февраль 2023 г. В качестве поискового запроса использовались термины согласно официальным терминам MeSH: “Extracorporeal Membrane Oxygenation” or “Membrane Oxygenation, Extracorporeal” or “ECMO Treatment” and “poisoning”.

Результаты. В данном обзоре приведены сведения о результатах применения вено-артериальной (ВА ЭКМО) и вено-венозной экстракорпоральной мембранной оксигенации (ВВ ЭКМО) при развитии рефрактерного кардиогенного шока, остановки сердечной деятельности и тяжелого острого респираторного дистресс-синдрома при острых химических отравлениях.

Выводы. Анализ данных показал, что у пациентов с острыми химическими отравлениями ниже частота осложнений и летальность при включении в комплексную терапию экстракорпоральной мембранной оксигенации/ЭКМО-сердечно-легочной реанимации по сравнению с больными, у которых показаниями к использованию данной методики послужили другие причины. Вероятно, это связано с тем, что пациенты в группе с острыми отравлениями моложе, у них меньше сопутствующих заболеваний, а экстракорпоральная мембранная оксигенация требуется, как правило, на более короткий период времени до выведения токсиканта из организма с помощью применения методов их элиминации и восстановления нарушенных функций.

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