The Influence of Lung Injury due to Mechanical Ventilation on the Initiation of Ecmo
The Influence of Lung Injury due to Mechanical Ventilation on the Initiation of Ecmo
复制标题
机械通气肺损伤对ECMO启动的影响
DOI：
10.1177/039139889501801003
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发表时间：
1995
期刊：
影响因子：
--
通讯作者：
H. Versmold
中科院分区：
文献类型：
--
作者：
H. Bartsch;H. Kössel;G. Brummer;W. Philippi;J. Waldschmidt;K. Eyrich;H. Versmold
在达到体外膜氧合(ECMO)的入院标准之前，新生儿可能需要积极的机械通气，这可能会导致肺损伤。问题是，这些婴儿是否存在气胸对预后有影响。21例转院接受ECMO的新生儿中，8例接受了ECMO治疗。21例新生儿中有9例发生气胸，采用常规机械通气，其中6例需要ECMO。出现气胸但不符合ECMO标准并保持氧合指数(01)在25至40范围内超过2天的婴儿预后较差。如果通过可接受的机械通气不能获得足够的氧合，而更积极的机械通气导致气胸，即使氧合指数低于40，也应该考虑ECMO。
Before the entry criteria for extracorporeal membrane oxygenation (ECMO) are met, newborns may require aggressive mechanical ventilation which may result in lung injury. The question arises whether the presence of a pneumothorax in these infants plays a role in the prognosis. Of the 21 newborns transferred to our hospital for ECMO, 8 were treated with ECMO. 9 of the 21 newborns developed a pneumothorax with conventional ventilation and 6 of these 9 newborns subsequently required ECMO. Infants who developed a pneumothorax but did not meet ECMO criteria and remained in the oxygenation index (01) range between 25 and 40 for more than 2 days had a poorer prognosis. If adequate oxygenation cannot be attained with acceptable mechanical ventilation and a more aggressive ventilation results in a pneumothorax, ECMO should be considered even if the oxygenation index is below 40.