To summarize the nursing experience of ECMO for a patient with anti-neutrophil cytoplasmic antibody（ANCA）associated vasculitis complicated with diffuse alveolar hemorrhage. It was difficult to maintain oxygenation and the alveolar bleeding continued,so vein-vein extracorporeal membrane oxygenation was used as adjuvant therapy. The key points of nursing included infection prevention and control,prone ventilation care,precision volume management,close monitoring of clotting and bleeding,phased early mobilization,personalized psychological support. Monitoring of applicability in the early stage of anticoagulant therapy and management after anticoagulant therapy were the characteristics and focus of this case. The patient was successfully removed from ECMO on the 11th day and withdrew from mechanical ventilation 2 days later,and he was transferred out of ICU on the 30th day and discharged successfully 17 days later.
ZHANG Runjie
,
GUO Hongyan
. Nursing of anti-neutrophil cytoplasmic antibody associated vasculitis treated with extracorporeal membrane oxygenation[J]. Chinese Journal of Emergency and Critical Care Nursing, 2023
, 4(10)
: 923
-926
.
DOI: 10.3761/j.issn.2096-7446.2023.10.012
[1] Kim MJ,Shin K.Interstitial lung disease and diffuse alveolar hemorrhage,the two key pulmonary manifestations in micro-scopic polyangiitis. Tuberc Respir Dis(Seoul）2021:84(4):255-262.
[2] 陆翠,苏禹同,滕佳临,等. 肉芽肿性多血管炎合并弥漫性肺泡出血一例报道并文献复习[J]. 中国全科医学,2020,23(18):2346-2350.
Lu C,Su YT,Teng JL,et al.Granulomatosis polyangiitis with diffuse alveolar hemorrhage:a case report and literature review[J]. Chin Gen Prac,2020,23(18):2346-2350.
[3] McMichael ABV,Ryerson LM,Ratano D,et al. 2021 ELSO Adult and Pediatric Anticoagulation Guidelines[J]. ASAIO Jour-nal,2022,68:303-310.
[4] Wen PH,Chan WH,Chen YC,et al.Non-heparinized ECMO serves a rescue method in a multitrauma patient combining pulmonary contusion and nonoperative internal bleeding:a case report and literature review[J]. World J Emerg Surg,2015, 10(15):303-310.
[5] 辛晨,魏丽丽,盖玉彪,等. 静脉-静脉体外膜肺氧合患者早期康复方案的构建[J]. 中华急危重症护理杂志,2022,3(4):305-311.
Xin C,Wei LL,Gai YB,et al.Construction of early rehabili-tation program for patients with veno-venous extracorporeal membrane oxygenation[J]. Chin J Emerg Criti Care Nurs,2022, 3(4):305-311.
