切换至 "中华医学电子期刊资源库"

第五届中国出版政府奖音像电子网络出版物奖提名奖

中国科技核心期刊

中国科学引文数据库(CSCD)来源期刊

中华重症医学电子杂志 ›› 2026, Vol. 12 ›› Issue (02) : 106 -111. doi: 10.3877/cma.j.issn.2096-1537.2026.02.002

年度进展

体外生命支持临床研究进展:2025
龚睿1, 余愿1, 张建成1, 杜中涛2, 侯晓彤2, 邱海波3, 尚游1,()   
  1. 1 430022 武汉,华中科技大学同济医学院附属协和医院重症医学科
    2 100013 北京,首都医科大学附属北京安贞医院心外危重症中心
    3 210009 南京,江苏省重症医学重点实验室 东南大学附属中大医院重症医学科
  • 收稿日期:2026-02-05 出版日期:2026-05-28
  • 通信作者: 尚游

Progress in clinical research of extracorporeal life support in 2025

Rui Gong1, Yuan Yu1, Jiancheng Zhang1, Zhongtao Du2, Xiaotong Hou2, Haibo Qiu3, You Shang1,()   

  1. 1 Department of Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
    2 Center for Cardiovascular Critical Care, Beijing Anzhen Hospital, Capital Medical University, Beijing 100013, China
    3 Jiangsu Provincial Key Laboratory of Critical Care Medicine, Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing 210009, China
  • Received:2026-02-05 Published:2026-05-28
  • Corresponding author: You Shang
引用本文:

龚睿, 余愿, 张建成, 杜中涛, 侯晓彤, 邱海波, 尚游. 体外生命支持临床研究进展:2025[J/OL]. 中华重症医学电子杂志, 2026, 12(02): 106-111.

Rui Gong, Yuan Yu, Jiancheng Zhang, Zhongtao Du, Xiaotong Hou, Haibo Qiu, You Shang. Progress in clinical research of extracorporeal life support in 2025[J/OL]. Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition), 2026, 12(02): 106-111.

2025年体外生命支持(ECLS)临床研究,在心脏支持方面,明确静脉-动脉体外膜氧合(VA-ECMO)获益人群需通过多项血流动力学指标筛选,标准化生理目标的集束化治疗可改善患者预后,微轴流泵在ST段抬高型心肌梗死(STEMI)合并重症心源性休克(CS)中推荐级别提升,体外心肺复苏(ECPR)强调快速启动与精准患者选择。呼吸支持方面,静脉-静脉体外膜氧合(VV-ECMO)在严重创伤、肺移植桥接等领域的应用指征进一步明确,俯卧位通气可降低部分急性呼吸窘迫综合征(ARDS)患者病死率,但需防控血小板减少症等并发症,标准化脱机策略可缩短治疗时长。而人工智能(AI)有助于ECMO的精准管理。总之,2025年ECLS临床研究凸显精准化、个体化原则,期待更多的临床研究提供精准诊疗方案以改善患者预后。本文梳理2025年度ECLS领域的最新临床研究成果,为临床实践提供最新的循证医学证据。

In 2025, clinical research in extracorporeal life support (ECLS) has further advanced the precision and individualized application of cardiac and respiratory support strategies. In the field of cardiac support, identification of patients most likely to benefit from veno-arterial extracorporeal membrane oxygenation (VA-ECMO) increasingly relies on comprehensive assessment using multiple hemodynamic parameters, while bundled management strategies incorporating standardized physiological targets have shown clinical outcomes. The recommendation level for microaxial flow pumps in patients with ST-segment elevation myocardial infarction (STEMI) complicated by severe cardiogenic shock has been upgraded. In addition, extracorporeal cardiopulmonary resuscitation (ECPR) emphasizes rapid deployment and precise patient selection. In terms of respiratory support, the indications for veno-venous extracorporeal membrane oxygenation (VV-ECMO) in severe trauma, lung transplantation bridging and other clinical settings have been further clarified. Prone positioning during ECMO support has been shown to reduce mortality in selected patients with acute respiratory distress syndrome (ARDS), although attention to complications such as thrombocytopenia remains essential. Furthermore, standardized weaning protocols may help shorten ECMO duration. Artificial intelligence also contributes to more precise ECMO management. In summary, advances in ECLS research in 2025 underscore the growing emphasis on precision medicine and individualized management, while highlighting the need for further clinical investigations to optimize patient selection and improve prognosis. This article reviews the latest clinical research findings in the field of ECLS for the year 2025, providing up-to-date evidence-based medical evidence for clinical practice.

1
Ostadal P, Rokyta R, Karasek J, et al. Extracorporeal membrane oxygenation in the therapy of cardiogenic shock: 1-year outcomes of the multicentre, randomized ECMO-CS trial [J]. Eur J Heart Fail, 2025, 27(1): 30-36.
2
Ostadal P, Vondrakova D, Rokyta R, et al. Cardiac index, SvO2 or pCO2 gap may determine benefit from ECMO in cardiogenic shock: post-hoc analysis of the multicenter, randomized ECMO-CS trial [J]. Crit Care, 2025, 29(1): 303.
3
Lim HS, Vondrakova D, Belohlavek J, et al. Diastolic perfusion pressure predicts response to inotropes and vasopressors and benefit from mechanical circulatory support in cardiogenic shock [J]. Circ Heart Fail, 2025, 18(7): e012847.
4
Sundermeyer J, Kellner C, Beer BN, et al. Timing of veno-arterial extracorporeal membrane oxygenation support in patients with cardiogenic shock [J]. Eur J Heart Fail, 2025, 27(1): 40-50.
5
Wang L, Wang K, Wang Y, et al. A simple VA-ECMO bundle in adult patients with cardiogenic shock: an analysis of ELSO registry [J]. EClinicalMedicine, 2025, 87: 103423.
6
Wang W, Tang R, Gu T, et al. The impact of different left heart decompression strategies and timing on VA-ECMO patients: a systematic review and network meta-analysis [J]. Int J Surg, 2025, 111(5): 3634-3637.
7
Lim Y, Kim MC, Lee SH, et al. Early left ventricular unloading after venoarterial extracorporeal membrane oxygenation: 1-year outcomes of the EARLY-UNLOAD randomized clinical trial [J]. Eur Heart J Acute Cardiovasc Care, 2025, 14(4): 203-211.
8
Feng SN, Liu WL, Kang JK, et al. Impact of left ventricular venting on acute brain injury in patients with cardiogenic shock: an extracorporeal life support organization registry analysis [J]. Crit Care Med, 2025, 53(12): e2476-e2486.
9
Fiorelli F, Vandenbriele C, Aboumarie HS, et al. Conventional versus pump -controlled retrograde trial off (PCRTO) weaning in VA-ECMO: exploring feasibility, physiological insights and benefits [J]. Crit Care, 2025, 29(1): 415.
10
Tavazzi G, Colombo CNJ, Klersy C, et al. Echocardiographic parameters for weaning from extracorporeal membrane oxygenation-the role of longitudinal function and cardiac time intervals [J]. Eur Heart J Cardiovasc Imaging, 2025, 26(2): 359-367.
11
Yang Y, Wang L, Li C, et al. Carbon dioxide elimination as a guide to venoarterial extracorporeal membrane oxygenation weaning: a prospective observational study [J]. Ann Intensive Care, 2025, 15(1): 157.
12
Combes A, Saura O, Nesseler N, et al. Levosimendan to facilitate weaning from ECMO in patients with severe cardiogenic shock: the LEVOECMO randomized clinical trial [J]. JAMA, 2026, 335(1): 60-69.
13
Rao SV, O'donoghue ML, Ruel M, et al. 2025 ACC/AHA/ACEP/NAEMSP/SCAI Guideline for the management of patients with acute coronary syndromes: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines [J]. J Am Coll Cardiol, 2025, 85(22): 2135-2237.
14
Møller JE, Beske RP, Engstrøm T, et al. Long-term outcomes of the DanGer Shock trial [J]. N Engl J Med, 2025, 393(10): 1037-1038.
15
Mikkelsen AD, Beske RP, Jensen LO, et al. Systolic Blood pressure and microaxial flow pump-associated survival in infarct-related cardiogenic shock: a post hoc analysis of the DanGer shock randomized clinical trial [J]. JAMA Cardiol, 2025, 10(11): 1157-1165.
16
Klein A, Beske RP, Hassager C, et al. Treating older patients in cardiogenic shock with a microaxial flow pump: is it DANGERous? [J]. J Am Coll Cardiol, 2025, 85(6): 595-603.
17
Udesen NLJ, Beske RP, Hassager C, et al. Microaxial flow pump hemodynamic and metabolic effects in infarct-related cardiogenic shock: a substudy of the DanGer shock randomized clinical trial [J]. JAMA Cardiol, 2025, 10(1): 9-16.
18
Arai R, Kojima K, Fukamachi D, et al. DanGer shock criteria and outcomes in acute myocardial infarction-related cardiogenic shock treated with Impella: the J-PVAD registry [J]. Eur Heart J, 2026, 47(4): 472-486.
19
Supady A, Bělohlávek J, Combes A, et al. Extracorporeal cardiopulmonary resuscitation for refractory cardiac arrest [J]. Lancet Respir Med, 2025, 13(9): 843-856.
20
Khoury J, Soumagnac T, Vimpere D, et al. Long-term heart function in refractory out-of-hospital cardiac arrest treated with prehospital extracorporeal cardiopulmonary resuscitation [J]. Resuscitation, 2025, 207: 110449.
21
Kasugai D, Okada Y, Mizutani Y, et al. The impact of hospital-level median door-to-extracorporeal cardiopulmonary resuscitation time on the prognosis of patients with refractory out-of-hospital cardiac arrest [J]. Crit Care Med, 2025, 53(10): e2025-e2032.
22
Kashiura M, Kishihara Y, Tamura H, et al. Sub-phenotypes in patients with out-of-hospital cardiac arrest who undergo extracorporeal cardiopulmonary resuscitation: a retrospective observational study from a multicenter registry [J]. Crit Care, 2025, 29(1): 316.
23
Kruit N, Burns B, Shearer N, et al. Pre-hospital ECPR for refractory cardiac arrest-the PRECARE pilot feasibility study [J]. Resuscitation, 2025, 212: 110631.
24
Erblich R, Swol J, Singer B, et al. Extracorporeal cardiopulmonary resuscitation in trauma patients: an analysis of the ELSO registry [J]. Resuscitation, 2026, 218: 110884.
25
Kawauchi A, Okada Y, Aoki M, et al. Clinical prediction score for patients with initial nonshockable rhythm receiving extracorporeal cardiopulmonary resuscitation for out-of-hospital cardiac arrest: development and internal validation [J]. J Am Heart Assoc, 2025, 14(17): e042734.
26
Kalra A, Wilcox C, Liu W, et al. Pulse oximetry and arterial blood gas oxygen saturation discrepancies and mortality in extracorporeal cardiopulmonary resuscitation patients: an extracorporeal life support organization registry analysis [J]. Crit Care Med, 2025, 53(8): e1610-e1619.
27
Taira T, Inoue A, Ijuin S, et al. Acute kidney injury after extracorporeal cardiopulmonary resuscitation for out-of-hospital cardiac arrest [J]. Crit Care Med, 2026, 54(1): 87-98.
28
Sato R, Hamahata NT, Hasegawa D, et al. Prolonged mechanical ventilation prior to venovenous extracorporeal membrane oxygenation and in-hospital mortality in patients with acute respiratory distress syndrome [J]. Crit Care Med, 2025, 53(11): e2318-e2322.
29
Zangbar B, Rafieezadeh A, Prabhakaran K, et al. Extracorporeal membrane oxygenation is associated with decreased mortality in non-acute respiratory distress syndrome patients following severe blunt thoracic trauma [J]. J Trauma Acute Care Surg, 2025, 98(4): 593-599.
30
Zhou AL, Jennings MR, Akbar AF, et al. Utilization and outcomes of nonintubated extracorporeal membrane oxygenation as a bridge to lung transplant [J]. J Heart Lung Transplant, 2025, 44(4): 661-669.
31
Schellongowski P, Darmon M, Eller P, et al. Acute respiratory distress syndrome in patients with cancer: the YELENNA prospective multinational observational cohort study [J]. Intensive Care Med, 2025, 51(10): 1809-1819.
32
Wang H, Cen Z, Liu X, et al. Use of extracorporeal membrane oxygenation in adult trauma patients with refractory acute cardiopulmonary failure: guideline from the Chinese society of extracorporeal life support 2025 [J]. Crit Care, 2025, 29(1): 334.
33
Pettenuzzo T, Balzani E, Sella N, et al. Prone positioning during veno-venous extracorporeal membrane oxygenation: a systematic review and meta-analysis [J]. Intensive Care Med, 2025, 51(5): 930-941.
34
Coppens A, Aissi James S, Roze H, et al. Optimum electrical impedance tomography-based PEEP and recruitment-to-inflation ratio in patients with severe ARDS on venovenous ECMO [J]. Crit Care, 2025, 29(1): 195.
35
Chen X, Xie J, Wang Y, et al. Impact of early PaCO2 and pH fluctuations on neurological outcomes in ARDS patients receiving VV ECMO: a retrospective cohort study from the CSECLS registry [J]. Ann Intensive Care, 2025, 15(1): 143.
36
Buchtele N, Tanaka K, Tuzzolino F, et al. Incidence, kinetics, and clinical impact of thrombocytopenia in venovenous ECMO: insights from the multicenter observational PROTECMO study [J]. Crit Care, 2025, 29(1): 349.
37
Temple FT, Simonova G, Passmore MR, et al. Storage duration of packed red blood cells transfused during veno-venous extracorporeal membrane oxygenation is associated with elevated pulmonary artery pressure and lung injury in a sheep model [J]. Crit Care, 2025, 29(1): 240.
38
Teijeiro-Paradis R, Munshi L, Ferguson ND, et al. Association of standardized liberation trials and duration of venovenous extracorporeal membrane oxygenation in patients with acute respiratory failure [J]. Ann Am Thorac Soc, 2025, 22(6): 897-904.
39
Chen S, Liu L, Hu D, et al. Effect of artificial intelligence in extracorporeal membrane oxygenation: a systematic review and meta-analysis [J]. Intensive Crit Care Nurs, 2026, 92: 104165.
40
Leng A, Bachina P, Liu O, et al. Enhancing survival prediction after venoarterial extracorporeal membrane oxygenation using machine learning [J]. ASAIO J, 2025, 71(12): e285-e285.
41
Hsu JC, Pai CH, Lin LY, et al. Machine learning-based first-day mortality prediction for venoarterial extracorporeal membrane oxygenation: the novel RESCUE-24 score [J]. ASAIO J, 2025, 72(2): 117-128.
[1] 侯晓彤. 中国体外生命支持:初心为舵,创新为帆[J/OL]. 中华重症医学电子杂志, 2026, 12(02): 101-105.
[2] 侯晓彤, 王粮山, 王可心. 体外生命支持:2024 年度进展与展望[J/OL]. 中华重症医学电子杂志, 2025, 11(02): 125-129.
[3] 许浩, 罗亮. 体外膜肺氧合支持期间新发感染的研究进展[J/OL]. 中华重症医学电子杂志, 2024, 10(03): 292-297.
[4] 李文哲, 潘鹏飞, 崔建, 于湘友. 体外生命支持技术临床应用的伦理学问题[J/OL]. 中华重症医学电子杂志, 2024, 10(02): 97-101.
[5] 席绍松, 朱英, 胡炜. 静脉-动脉体外膜氧合支持患者的左心减负[J/OL]. 中华重症医学电子杂志, 2020, 06(02): 132-139.
阅读次数
全文


摘要


AI


AI小编
你好!我是《中华医学电子期刊资源库》AI小编,有什么可以帮您的吗?