循環器ジャーナル70巻4号

2022年10月発行

特集 循環器救急診療・集中治療を極める Ⅳ．心停止を救命する

ECPR : 心肺蘇生症例に対するECMOの導入

著者： 須賀将文¹ 井上明彦¹

所属機関： ¹兵庫県災害医療センター救急部

ページ範囲：P.538 - P.542

Point
・ECPRは，従来のCPRでは救命が困難な心停止症例を救うことができる．
・ただし合併症，コスト面などの害も多く，適切な適応選定が重要である．
・導入だけでなく，その後の合併症への対応，ICU管理なども重要となる．

参考文献

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11）Otani T, Sawano H, Natsukawa T, et al : Low-flow time is associated with a favorable neurological outcome in out-of-hospital cardiac arrest patients resuscitated with extracorporeal cardiopulmonary resuscitation. J Crit Care 48 : 15-20, 2018

12）Soar J, Böttiger BW, Carli P, et al : European Resuscitation Council Guidelines 2021 : Adult advanced life support. Resuscitation 161 : 115-151, 2021

13）日本循環器学会，日本医学放射線学会，日本胸部外科学会，他：肺血栓塞栓症および深部静脈血栓症の診断，治療，予防に関するガイドライン（2017年改訂版）．2018

14）Kashiura M, Sugiyama K, Tanabe T, et al : Effect of ultrasonography and fluoroscopic guidance on the incidence of complications of cannulation in extracorporeal cardiopulmonary resuscitation in out-of-hospital cardiac arrest : a retrospective observational study. BMC Anesthesiol 17 : 4, 2017

15）Otani T, Sawano H, Natsukawa T, et al : D-dimer predicts bleeding complication in out-of-hospital cardiac arrest resuscitated with ECMO. Am J Emerg Med 36 : 1003-1008, 2018

16）Swol J, Belohlávek J, Brodie D, et al : Extracorporeal life support in the emergency department : A narrative review for the emergency physician. Resuscitation 133 : 108-117, 2018