Abstract:
Objective To investigate the effects of different extracorporeal membrane oxygenation (ECMO) bypass modes on the prognosis of patients with combined pulmonary fibrosis and emphysema (CPFE) during lung transplantation.
Methods A retrospective analysis was conducted on 44 CPFE patients who underwent lung transplantation, and they were divided into the venous-venous ECMO (VV-ECMO) group (30 cases) and the venous-arterial ECMO (VA-ECMO) group (14 cases). The preoperative, intraoperative, postoperative and follow-up related indicators of two groups were compared.
Results Compared with the VV-ECMO group, the patients in the VA-ECMO group were younger, had higher pulmonary artery pressure before surgery, fewer posterolateral incision types, longer operation times, and higher incidence of postoperative bronchopleural fistula (all P<0.05). The pulmonary artery pressure decreased after surgery in both groups, with a greater decrease in the VA-ECMO group (P<0.05). There was no statistically significant difference in postoperative survival rates between the two groups (P>0.05).
Conclusions Both VA-ECMO and VV-ECMO are safe and effective in lung transplant patients with CPFE. The bypass mode has no significant impact on the short and medium-term prognosis of the patients. VA-ECMO is more suitable for patients with higher preoperative pulmonary artery pressure.
下载: