Effect of prone ventilation on extracorporeal membrane oxygenation support in ICU
俯卧位通气对ICU体外膜肺氧合支持治疗患者的影响

摘要

目的 探讨在ICU体外膜肺氧合（ECMO）支持治疗患者中实施俯卧位通气（PPV）干预的临床效果。方法 选取2020年1月至2024年12月本院ICU收治的80例行ECMO支持治疗患者，根据随机数字表法分组，各40例。对照组实施常规仰卧位通气干预，观察组实施PPV干预。对比两组在T0（ECMO治疗前）、T1（ECMO治疗后）、T2（体位干预第1d）、T3（体位干预第3d）、T4（体位干预第5d）的动脉血气指标（SaO2/动脉血氧饱和度、PaO2/血氧分压），记录且对比两组的ECMO成功撤机率和ICU住院第7d、14d、28d的死亡率。结果 与T0时间点相比，两组在T1-T4时间点的SaO2、PaO2动脉血气指标均有提高，且观察组高于对照组（P＜0.05）；观察组的ECMO成功撤机率高于对照组，且患者在ICU住院第7d、14d、28d的死亡率低于对照组（P＜0.05）。结论 对ICU内行ECMO支持治疗患者实施PPV干预能提高患者呼吸功能和成功撤机率，降低患者的死亡率，值得临床推广。

Abstract

Objective To investigate the clinical effect of prone ventilation (PPV) intervention in patients with extracorporeal membrane oxygenation (ECMO) in ICU.
Methods From January 2020 to December 2024, 80 patients receiving ECMO support treatment in ICU of our hospital were selected and divided into 40 patients each according to random number table method. The control group received routine supine ventilation intervention, and the observation group received PPV intervention. Arterial blood gas indexes (SaO2/ arterial oxygen saturation, PaO2/ partial pressure of blood oxygen) of the two groups were compared in T0 (before ECMO treatment), T1 (after ECMO treatment), T2 (1d after body position intervention), T3 (3d after body position intervention) and T4 (5d after body position intervention). The success rate of ECMO withdrawal and the mortality rate at day 7, day 14 and day 28 of ICU admission were recorded and compared between the two groups.
Results Compared with T0 time points, the arterial blood gas indexes of SaO2 and PaO2 in both groups were increased at T1-T4 time points, and the observation group was higher than the control group (P < 0.05). The success rate of ECMO withdrawal in the observation group was higher than that in the control group, and the mortality rate on the 7th, 14d and 28d of ICU admission was lower than that of the control group (P < 0.05).
Conclusion   The implementation of PPV intervention in ICU patients receiving ECMO support treatment can improve the respiratory function and the probability of successful withdrawal, and reduce the mortality of patients, which is worthy of clinical promotion.