| ID |
原文 |
译文 |
| 1177 |
1）初始气流调节，Flow:sweepgas=1:1,基本目标维持PaCO2<45mmHg，对于合并COPD患者应该PaCO2<80%基础水平；
|
(1) The initial air flow is set to be Flow: sweep gas = 1:1. The basic target is to maintain PaCO2 < 45mmHg. For the patients complicated with COPD, PaCO2 < 80% basal level.
|
| 1178 |
2）应该保留患者自主呼吸强度，自主呼吸频率respiratoryrate,
10
| (2) The patient’s spontaneous Respiratory strength and Respiratory rate (RR) should be maintained, with 10 < RR < 20 and without chief complaint of breathing difficulty from the patient.
|
|
| 1179 |
3）V-A模式sweepgas设定应该保证氧合器膜后血流PH：7.35-7.45。
|
(3) The sweep gas setup of the V-A mode needs to ensure the 7.35-7.45 PH value of the bloodstream out of the oxygenator membrane.
|
| 1180 |
抗凝与出血防范
|
Anti-Coagulation and Bleeding Prevention
|
| 1181 |
1）初始上机肝素应用，对于无活动性出血及无内脏出血且血小板>50×10
/L，首剂负荷量推荐50IU/kg；
|
(1) For the patients without active bleeding, without visceral bleeding, and with platelet count > 50×109/L, the recommended initial heparin dosage is 50 U/kg.
|
| 1182 |
2）合并出血风险或血小板<50×10^9/L，肝素首剂负荷量25IU/kg；
|
(2) For the patients complicated with bleeding or with platelet count < 50×109/L, the
recommended initial heparin dosage is 25 U/kg.
|
| 1183 |
3）抗凝维持剂量目标建议以aPTT(活化凝血酶原时间)40-60sec为目标，同时参考D-dimer的变化趋势；
|
(3) The activated partial thromboplastin time (aPPT) being 40 —60 sec is proposed to be
the target of anticoagulation maintenance dosage. The trend of D-dimer change should be considered at the same time.
|
| 1184 |
4）无肝素运行建议，对于出现需要控制的活动性出血，或者致命性出血，在无法停止ECMO支持的情况下，全肝素涂层环路与插管且血流量>3L/min，可以考虑进行无肝素运行，建议运行时间<24h，且需要准备替换设备与耗材；
|
(4) Heparin-free operation may be per formed in the following circumstances: the ECMO support must continue but there is fatal bleeding or active bleeding that has to be controlled; whole heparin coated loop and catheterization with blood flow > 3 L/min.
The recommend operation time < 24 hour. Replacement devices and consumables need to be prepared.
|
| 1185 |
5）关于肝素抵抗，部分肝素使用条件下，出现aPTT无法达标，且凝血发生，应该监测血浆抗凝血酶III（ATIII）活性，若出现活性降低，需要补充新鲜冰冻血浆来恢复肝素敏感性；
|
(5) Heparin resistance. Under some conditions of heparin usage, aPTT is not able to reach the standard and blood coagulation happens. In this case, the activity of plasma antithrombin III (ATIII) needs to be monitored. I f the activity reduces, fresh frozen plasma needs to be supplemented to restore heparin sensitivity.
|
| 1186 |
6）关于肝素相关性血小板减少症，heparin induced thrombopenia（HIT）。怀疑HIT发生，建议采用血浆置换治疗，或者采用阿加曲班药物替代。
|
(6) Heparin induced thrombopenia (HIT). When HIT happens, we recommend to perform plasma exchange therapy, or to replace heparin with argatroban.
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