Local experience with extracorporeal membrane oxygenation in children with acute fulminant myocarditis.
Local experience with extracorporeal membrane oxygenation in children with acute fulminant myocarditis.
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急性暴发性心肌炎儿童体外膜肺氧合的当地经验
DOI：
10.1371/journal.pone.0082258
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发表时间：
2013
期刊：
影响因子：
3.7
通讯作者：
Ye S
中科院分区：
文献类型：
--
作者：
Ning B;Zhang C;Lin R;Tan L;Chen Z;Yu J;Liu T;Yang Z;Ye S
为分析体外膜氧合（ECMO）治疗急性暴发性心肌炎患儿的临床效果，回顾性分析2009年2月至2012年11月浙江大学附属儿童医院重症监护病房（ICU）收治的5例急性暴发性心肌炎患儿的资料。研究组包括两名男孩和三名女孩，年龄从9岁到13岁（中位数为10岁）。体重25至33公斤（平均29.6公斤）。他们通过静脉-动脉ECMO模型进行体外膜氧合（ECMO），平均ECMO支持时间为89.8 h （40-142 h）。5例患儿均建立体外循环。经ECMO治疗后，4例存活患儿心率、血压、血氧饱和度均有明显改善。这4例患儿均成功脱离ECMO，出院时无机器，生存率为80%（4/5）。一个孩子仍然依赖机器而死。死亡原因是无法恢复的心脏功能和多器官衰竭。ECMO期间并发症包括缝合线出血3例，急性溶血性肾功能衰竭合并缝合线出血1例，高血糖1例。随访4 ~ 50个月，4例存活患儿心功能恢复正常，其他脏器功能无异常。ECMO在急性暴发性心肌炎中的应用，即使是在发病率较低的局部中心，仍然是一种有效的方法。更大的研究来确定ECMO放置的最佳时机，以指导当地中心是有必要的。
To analyze the clinical effect of extracorporeal membrane oxygenation (ECMO) in children with acute fulminant myocarditis, we retrospectively analyzed the data of five children with acute fulminant myocarditis in the intensive care unit (ICU) at the Affiliated Children’s Hospital, Zhejiang University from February 2009 to November 2012. The study group included two boys and three girls ranging in age from 9 to 13 years (median 10 years). Body weight ranged from 25 to 33 kg (mean 29.6 kg). They underwent extracorporeal membrane oxygenation (ECMO) through a venous-arterial ECMO model with an average ECMO supporting time of 89.8 h (40–142 h). Extracorporeal circulation was established in all five children. After treatment with ECMO, the heart rate, blood pressure, and oxygen saturation were greatly improved in the four children who survived. These four children were successfully weaned from ECMO and discharged from hospital machine-free, for a survival rate of 80% (4/5). One child died still dependent on the machine. Cause of death was irrecoverable cardiac function and multiple organ failure. Complications during ECMO included three cases of suture bleeding, one case of acute hemolytic renal failure and suture bleeding, and one case of hyperglycemia. During the follow-up period of 4–50 months, the four surviving children recovered with normal cardiac function and no abnormal functions of other organs. The application of ECMO in acute fulminant myocarditis, even in local centers that experience low incidence of this disease, remains an effective approach. Larger studies to determine optimal timing of placement on ECMO to guide local centers are warranted.
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影响因子：
37.8
作者：
Almond, Christopher S.;Singh, Tajinder P.;Thiagarajan, Ravi R.
通讯作者：
Thiagarajan, Ravi R.
影响因子：
3.3
作者：
Kato, S;Morimoto, S;Hishida, H
通讯作者：
Hishida, H
影响因子：
4.1
作者：
Fleming, Geoffrey M.;Gurney, James G.;Annich, Gail M.
通讯作者：
Annich, Gail M.
DOI：
10.1253/jcj.65.961
发表时间：
2001-11-01
期刊：
JAPANESE CIRCULATION JOURNAL-ENGLISH EDITION
影响因子：
--
作者：
Kodama, M;Oda, H;Izumi, T
通讯作者：
Izumi, T
DOI：
10.1006/clin.1993.1117
发表时间：
1993-08-01
期刊：
CLINICAL IMMUNOLOGY AND IMMUNOPATHOLOGY
影响因子：
--
作者：
LIEBERMAN, EB;HERSKOWITZ, A;BAUGHMAN, KL
通讯作者：
BAUGHMAN, KL