From general extracorporeal membrane oxygenation guidelines to obstetric application: an interpretation of core principles and adaptation
10.3760/cma.j.cn431274-20250722-00973
- VernacularTitle:从通用ECMO指南到产科应用：核心原则与适应性解读
- Author:
Zigang LIU
1
;
Youmei CHEN
;
Yongmei ZHAO
;
Dongcheng LI
;
Quan TANG
;
Quanfu ZHANG
Author Information
1. 香港中文大学妇女儿童医学中心(深圳)心血管外科，深圳 518100
- Publication Type:Journal Article
- Keywords:
Extracorporeal membrane oxygenation;
Obstetric critical illness;
Anticoagulation
- From:
Journal of Chinese Physician
2025;27(9):1304-1308
- CountryChina
- Language:Chinese
-
Abstract:
Extracorporeal membrane oxygenation (ECMO) serves as an advanced life support technology and plays a critical role in treating critically ill patients with severe cardiopulmonary failure. However, the unique physiological and pathological changes during pregnancy present numerous challenges and special considerations for the application of ECMO in obstetrics. Given the current lack of unified guidelines specifically for obstetric ECMO, clinical practice often relies on adapting general ECMO guidelines in combination with obstetric-specific factors. This article systematically reviews the core principles of existing general ECMO guidelines, provides an in-depth analysis of the impact of gestational physiological and pathological characteristics on ECMO application, and discusses the particularities and necessary adaptations of obstetric ECMO in terms of indications, anticoagulation strategies, parameter adjustment, multidisciplinary collaboration, and emergency management. Furthermore, it proposes strategies suitable for domestic clinical practice. The article also addresses existing difficulties and limitations not covered by current guidelines and calls for the urgent development of specialized obstetric ECMO guidelines to provide clinicians with more standardized and safer decision-making support, ultimately improving outcomes for critically ill pregnant patients and newborns.
