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药物中毒

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中毒患者联合应用脂肪乳剂和动静脉体外膜肺氧合(VA-ECMO)的不良反应
原作者: Bryan Hayes, 江利冰 翻译, 发布日期:2015-12-07

Title: Adverse Effects of Combined Lipid Emulsion + VA-ECMO in Poisoned Patients
题目:中毒患者联合应用脂肪乳剂和动静脉体外膜肺氧合(VA-ECMO)的不良反应
Author: Bryan Hayes
作者:Bryan Hayes
翻译:江利冰 校对:肖锋

A new review summarized published adverse effects when IV lipid emulsion is used along with venous-arterial extracorporeal membrane oxygenation (VA-ECMO) in patients with cardiotoxic drug poisoning.
Not surprisingly, running fat through the ECMO circuit can cause some issues. Here's what's been published:
一项最新的综述总结了当具有心脏毒性剂中毒时,联合使用静脉注射脂肪乳剂和动静脉体外膜肺氧合的不良反应。果然,在体外膜肺环路中输送脂肪会引起一些问题。以下是发表的内容:
• cracking of stopcocks
• 活塞的破裂
• fat emulsion agglutination
• 脂肪乳剂的凝集
• clogging and associated malfunction of the membrane oxygenator
• 堵塞以及相关的膜氧合器的功能障碍
• increased blood clot formation in the circuit
• 环路中血栓形成增加

It's unclear how these findings should change management if using both treatment modalities, but at the very least, be aware that fat depostion in the VA-ECMO circuits and increased blood clot formation can occur.
目前还不清楚这些发现会怎么改变同时使用这两种治疗方法时的处理策略,但是至少应该意识到当脂肪乳在动静脉体外膜肺环路中输送时,血栓的形成会增加。
References
参考文献
Lee HM, et al. What are the adverse effects associated with the combined use of intravenous lipid emulsion and extracorporeal membrane oxygenation in the poisoned patient? Clin Toxicol. 2015 Jan 29. [Epub ahead of print, PMID 25634667]
http://www.ncbi.nlm.nih.gov/pubmed/25634667