Nursing strategies for critically ill patients treated with ECMO combined with CRRT
ECMO联合CRRT治疗重症患者的护理策略

摘要

目的 探讨ECMO（体外膜肺氧合）联合CRRT（连续性肾脏替代治疗）治疗重症患者中的护理策略。方法 选择2022年11月-2025年11月我院急诊收治的25例心/肺功能衰竭重症患者为研究对象，基于随机双盲原则分为对照组（n=12）和研究组（n=13）。对照组患者接受常规护理方案干预，研究组患者应用综合护理方案，比较两组患者护理前后心/肺功能指标变化情况。结果 两组患者干预前心/肺功能各项指标均无显著性差异（P>0.05），干预后研究组患者LVEF（左心室射血分数）、CI（心脏指数）、PaO2（氧合指数）均较前显著提升，BNP（B型利纳肽）、PaCO2（动脉血二氧化碳分压）显著下降且均优于同期对照组（P<0.05）。结论 在ECMO联合CRRT治疗的重症患者中，实施有效的综合护理策略，有助于更好的改善患者的心肺功能，促进氧合与通气，值得在临床实践中推广应用。

Abstract

Objective To explore the nursing strategies in the treatment of critically ill patients with ECMO (extracorporeal membrane oxygenation) combined with CRRT (Continuous renal Replacement Therapy).
Methods Twenty-five severe patients with heart/lung failure admitted to the emergency department of our hospital from November 2022 to November 2025 were selected as the research subjects and divided into the control group (n=12) and the study group (n=13) based on the principle of random double-blind. Patients in the control group received the intervention of the conventional nursing plan, while patients in the study group were treated with the comprehensive nursing plan. The changes of cardiac/pulmonary function indicators of the two groups of patients before and after nursing were compared.
Results Before the intervention, there were no significant differences in various indicators of cardiac/pulmonary function between the two groups of patients (P>0.05). After the intervention, the LVEF (left ventricular ejection fraction), CI (cardiac index), and PaO2 (oxygenation index) of the patients in the study group were significantly increased compared with before. BNP (B-type natriuretic) and PaCO2 (partial pressure of carbon dioxide in arterial blood) decreased significantly and were both better than those of the control group in the same period (P<0.05).
Conclusion   In critically ill patients treated with ECMO combined with CRRT, the implementation of effective comprehensive nursing strategies is conducive to better improving the cardiopulmonary function of patients, promoting oxygenation and ventilation, and is worthy of promotion and application in clinical practice.