Objective To summarize the experience of fixed-wing aircraft transport for critically ill patients supported by extracorporeal membrane oxygenation(ECMO).Methods Data of 11 ECMO-supported patients transported by fixed-wing aircraft from May 2017 to March 2023 by the Beijing Red Cross 999 Aero-Medical Rescue Team in collaboration with relevant medical units were retrospectively collected and analyzed.The precautions and potential adverse events during fixed-wing aircraft transport of ECMO patients were summarized.Results Of the 11 patients,9 were male and 2 were female,with an average age of(56.6±16.6)years.Ten patients were diagnosed with severe pneumonia,and one patient was diagnosed with cardiomyopathy complicated by cardiogenic shock.Ten patients received veno-venous(V-V)ECMO,and one patient received veno-arterial(V-A)ECMO.Two patients(18%)were transported by B-1999 fixed-wing aircraft,while nine patients(82%)were transported by B-5999 fixed-wing aircraft,with a flight distance of(713.9±388.6)km,flight time of(1.5±0.7)h,and total transport time of(4.4±0.8)h.The transport medical team consisted of four members(two doctors and two nurses).All patients were successfully transported,with two patients experiencing adverse reactions during transport,including decreased heart rate and decreased partial pressure of oxygen during flight.Conclusion Fixed-wing aircraft aerial medical rescue for ECMO patients is safe and feasible with a professional and experienced ECMO medical team and adequate equipment preparation.
百日咳是由于百日咳鲍特菌感染而引起的一种急性呼吸道传染病,人群普遍易感,重症可致死,至今仍然是儿童感染性疾病致死的主要原因之一.近年全球百日咳发病率呈显著增长趋势[1].2016年世界卫生组织数据显示全球百日 咳139 535例,病死率 4％[2].体外膜氧合(extracorporeal mem-brane oxygenation,ECMO)是一种用于常规治疗无效的、可逆的心或(和)肺功能衰竭患者的心肺支持技术,为心或(和)肺基础疾病恢复提供时间,最早是在1990年用于百日 咳的治疗,但至今其生存率并无改善趋势.本文总结了本院应用静脉-静脉(vein-venous,V-V)ECMO救治1例重症百日 咳婴儿的临床资料及经验.
三尖瓣关闭不全(TR)是较为常见的心脏瓣膜疾病,其发病率高,治疗难度大.近年来,经导管三尖瓣置换术(TTVR)已成为目前心脏介入治疗TR的主要方式之一.但由于三尖瓣是空间立体结构,具有复杂的瓣下结构,病变多样化,传统的经食管超声和CT分析都具有一定的局限性.随着心血管三维(3D)打印技术的不断发展,可以利用3D打印的心脏模型提供更多传统影像学检查难以显示的丰富信息.近年来三尖瓣的数字化建模及3D打印方法取得了实质性的进展和突破,已成为TTVR围手术期评估的重要方法和手段.本综述着重就3D打印在TTVR术中应用的现状、研究进展以及未来发展方向进行了阐述.
目标导向灌注(GDP),作为一种近年来提出的整合各种监测手段的个体化心肺转流(CPB)灌注策略,已越来越多地应用于心脏外科领域.具体是通过监测CPB期间氧供、氧耗、二氧化碳生成指数等氧代谢指标来指导血液稀释、灌注流量及血压管理,在提高CPB质量、降低心脏手术后并发症及改善患者预后中具有一定的价值.通过回顾近年相关临床研究,介绍GDP的基本概念、监测指标,并对GDP在心脏手术中的应用及研究进展进行综述,为其进一步的临床实施提供指导依据.
目的 总结异种异位心脏移植动物实验的经验,旨在为成功转化基因编辑猪心脏异种移植临床应用积累研究基础.方法 2022年10月在1只恒河猴的腹腔内完成了异位猪心脏移植."猪-恒河猴"异位心脏异种移植实验从多个方面对受体进行精细化管理,围术期针对免疫排斥和凝血功能障碍,维持供体心脏功能,延长受体生存时间,尽可能保证其生存和生活质量.结果 受者存活20天,死于凝血功能障碍.结论 为了克服免疫排斥、跨物种感染、凝血功能障碍等致命障碍,仍需要大量的临床前动物实验.
