Determinants of success in pediatric cardiac patients undergoing extracorporeal membrane oxygenation.
Determinants of success in pediatric cardiac patients undergoing extracorporeal membrane oxygenation.
复制标题
儿科心脏病患者接受体外膜肺氧合成功的决定因素。
DOI：
10.1016/s0003-4975(95)00238-3
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发表时间：
1995
期刊：
影响因子：
--
通讯作者：
R. Freedom
中科院分区：
文献类型：
--
作者：
M. Black;J. Coles;W. Williams;I. Rebeyka;G. Trusler;D. Bohn;C. Gruenwald;R. Freedom
目的探讨体外膜氧合(ECMO)心脏复苏的可能预测因素及ECMO支持的适用范围。方法收集1994年1月前在儿童医院接受ECMO治疗的31例心力衰竭患儿的资料。结果31例患儿中14例(45%)成功脱机。根据ECMO的最初适应症，明显有两组不同的儿童：有心脏手术后心肌功能障碍的儿童(n=25)和有心肌病或心肌炎的儿童(n=6)。心脏切开术后残留缺损者(n=10)无ECMO存活。6例心肌病或心肌炎患儿中有4例成功脱机。在任何一组患者中，ECMO支持超过6天都未能使心肌复苏；在我们的研究中，所有试图打破这一“时间障碍”的尝试都不可避免地失败。结论心脏手术后残留的缺陷是ECMO的禁忌症。如果排除有残存缺陷的儿童，几乎70%的儿童可以成功脱离ECMO，几乎所有的恢复都发生在ECMO的前6天。
BACKGROUNDThe purpose of this retrospective study is to determine the possible predictors of successful cardiac recovery using extracorporeal membrane oxygenation (ECMO) and the practical limits of ECMO support.METHODSInformation was gathered on 31 consecutive children with myocardial failure who could not be resuscitated with other means and underwent ECMO at the Hospital for Sick Children before January 1994.RESULTSOf the children who underwent ECMO as a means of cardiac rescue, 14/31 (45%) were weaned successfully. Two distinct groups of children were evident based on their initial indications for ECMO: those who had postcardiotomy myocardial dysfunction (n = 25) and those with cardiomyopathy or myocarditis (n = 6). Children with residual defects after cardiotomy (n = 10) did not survive ECMO. Four of the 6 children with cardiomyopathy or myocarditis were weaned successfully. In either group of patients ECMO support beyond 6 days failed to resuscitate the myocardium; all attempts to violate this “time barrier” in our study inevitably failed.CONCLUSIONSPostcardiotomy residual defects are a contraindication to ECMO. If children with residual defects are excluded, successful weaning from ECMO can be achieved in almost 70%, with almost all recovery occurring with the first 6 days of ECMO.
心脏手术后心源性休克患者的心室辅助泵血。
DOI：
10.1056/nejm198112313052702
发表时间：
1981
期刊：
The New England journal of medicine
影响因子：
--
作者：
Pierce,WS;Parr,GV;Myers,JL;PaeJr,WE;Bull,AP;Waldhausen,JA
通讯作者：
Waldhausen,JA