MD-OncoMD-OncoMD-Onco2782-32022782-6171Publishing House ABV Press8810.17650/2782-3202-2023-3-4-52-59RARE AND COMPLEX CLINICAL SITUATIONS: DIAGNOSIS AND SELECTION OF TREATMENT TACTICSРЕДКИЕ И СЛОЖНЫЕ КЛИНИЧЕСКИЕ СИТУАЦИИ: ДИАГНОСТИКА И ВЫБОР ТАКТИКИ ЛЕЧЕНИЯUse of veno-venous extracorporeal membrane oxygenation in a female patient with severe acute respiratory distress syndrome and peri-intubation cardiac arrest. Clinical observationПрименение веновенозной экстракорпоральной мембранной оксигенации у пациентки с тяжелым острым респираторным дистресс-синдромом и периинтубационной остановкой сердца. Клиническое наблюдениеhttps://orcid.org/0000-0002-3550-9881OskolkovA. V.ОсколковА. В.
Russian Federation

Artem Vladimirovich Oskolkov

111 1st Uspenskoe Shosse, Lapino, Moscow region 143081

Артем Владимирович Осколков

143081 Московская обл., д. Лапино, 1-е Успенское шоссе, 111

a.oskolkov@mcclinics.ruhttps://orcid.org/0000-0003-1326-1392AntonetsM. V.АнтонецМ. В.
Russian Federation

111 1st Uspenskoe Shosse, Lapino, Moscow region 143081

143081 Московская обл., д. Лапино, 1-е Успенское шоссе, 111

https://orcid.org/0000-0002-4220-1762BagdasaryanP. M.БагдасарянП. М.
Russian Federation

111 1st Uspenskoe Shosse, Lapino, Moscow region 143081

143081 Московская обл., д. Лапино, 1-е Успенское шоссе, 111

https://orcid.org/0000-0003-2477-7765OvsyannikovG. A.ОвсянниковГ. А.
Russian Federation

100a Lakhtinskiy Ave., St. Peterburg 197229

197229 Санкт-Петербург, Лахтинский пр-кт, 100а

Clinical Hospital “Lapino” of the “Mother and Child” Group of companiesКлинический госпиталь «Лапино» группы компаний «Мать и дитя»Clinical Hospital “Lakhta” of the “Mother and Child” Group of companiesКлинический госпиталь «Лахта» группы компаний «Мать и дитя»071220233452590712202307122023Copyright ©; 2023, ABV-PressCopyright ©; 2023, АБВ-пресс2023ABV-PressАБВ-прессhttps://mdonco.abvpress.ru/jour/about/editorialPolicieshttps://mdonco.abvpress.ru/jour/article/view/88

Acute respiratory distress syndrome (ARDS) is a life-threatening form of respiratory failure which can occur in people of any age. It comprises about 10 % of all admissions in intensive care units. The cornerstone of treatment of severe forms of this disorder is protective mechanical ventilation but in patients with initial hypoxia and/or hypotension tracheal intubation is associated with the risk of significant hemodynamic abnormalities. Mortality from severe forms of ARDS remains high. COVID-19 pandemic led to worldwide wider use of such techniques of respiratory support as high-flow nasal oxygen therapy and non-invasive ventilation, the necessity of which is proposed to be used as one of classifying signs of ARDS in addition to the Berlin criteria. If the respiratory therapy is ineffective, veno-venous extracorporeal membrane oxygenation is used for gaseous exchange and decreasing undesirable effects of high pressure in the respiratory pathways. The success of its application strongly depends on the optimal timing of its initialization. The performance of this technique is associated with a number of complications (hemorrhage, thrombosis, sepsis, etc.). Effective treatment of ARDS requires utilization of a large amount of resources and educated staff.

Острый респираторный дистресс-синдром (ОРДС) – жизнеугрожающая форма дыхательной недостаточности, которая может возникнуть у людей любого возраста и на которую приходится примерно 10 % всех госпитализаций в отделения интенсивной терапии. Краеугольным камнем лечения тяжелых форм данного состояния остается протективная искусственная вентиляция легких, но у пациентов с исходной гипоксией и/или гипотензией интубация трахеи сопряжена с риском значительных гемодинамических нарушений. Смертность от тяжелых форм ОРДС по-прежнему высока. Пандемия COVID-19 привела к расширению использования врачами всего мира таких методик респираторной поддержки, как высокопоточная назальная оксигенотерапия и неинвазивная искусственная вентиляция легких, необходимость применения которых предложено использовать как один из классифицирующих признаков ОРДС в дополнение к Берлинским критериям. При неэффективности респираторной терапии для осуществления газообмена и снижения нежелательных эффектов высокого давления в дыхательных путях применяется веновенозная экстракорпоральная мембранная оксигенация. Успешность ее проведения во многом определяется оптимальным временем инициации процедуры. Выполнение данной методики сопряжено с целым рядом осложнений (кровотечение, тромбозы, сепсис и др.). Для эффективного лечения ОРДС необходимо привлечение большого объема ресурсов и наличие обученного персонала.

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