Extracorporeal membrane oxygenation for the treatment of children with severe hemodynamic alteration in perioperative cardiovascular surgery
Extracorporeal membrane oxygenation for the treatment of children with severe hemodynamic alteration in perioperative cardiovascular surgery
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体外膜肺氧合治疗心血管手术围术期严重血流动力学改变的儿童
DOI：
10.1007/s12519-010-0013-6
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发表时间：
2010-02
影响因子：
8.7
通讯作者：
Lin, Ru
中科院分区：
文献类型：
--
作者：
Ye, Li-Fen;Fan, Yong;Tan, Lin-Hua;Shi, Li-Ping;Zhang, Ze-Wei;Du, Li-Zhong;Shu, Qiang;Lin, Ru
本文综述了体外膜氧合（ECMO）在儿童心血管手术围手术期严重血流动力学改变中的应用。方法2007年7月至2008年7月，对4例先天性心脏病（CHD）患儿（3男1女，年龄6天~ 4岁，体重2.8 ~ 15kg）合并严重心力衰竭和/或低氧血症行心血管手术围手术期ECMO心肺支持治疗。回顾性分析4例患儿的病历。结果4例患儿中2例存活，2例死亡。由于动脉转换手术后严重的低输出综合征，幸存者接受静脉动脉（VA） ECMO治疗。他们分别在ECMO支持22小时和87小时成功脱机，并在ECMO移植20天和58天后出院。另一名接受静脉-静脉ECMO治疗的男孩死于严重低氧血症和代谢性酸中毒。另一名患有VSD的女孩，因未能脱离体外循环而接受VA ECMO治疗，在ECMO移植后11小时死于不可逆的心力衰竭。主要并发症包括肺出血、血液填塞、手术部位出血、溶血和高胆红素血症。结论secmo是治疗严重心衰患者围手术期的有效方法。ECMO成功的关键是适应证的选择、建立ECMO的时间和ECMO过程中并发症的处理。
BackgroundThis article summarizes the use of extracorporeal membrane oxygenation (ECMO) for the treatment of children with severe hemodynamic alteration in perioperative cardiovascular surgery.MethodsFour children with congenital heart disease (CHD) (3 boys and 1 girl, aged 6 days to 4 years and weighing 2.8–15 kg) associated with severe heart failure and/or hypoxemia were treated with ECMO cardiopulmonary support in perioperative cardiovascular surgery between July 2007 and July 2008. We retrospectively analyzed the medical records of the 4 children.ResultsOf the 4 children, 2 survived and 2 died. The survivors were treated with venoarterial (VA) ECMO due to severe low output syndrome after arterial switch operation. They were weaned successfully from 22-hour and 87-hour ECMO support, and discharged 20 days and 58 days after ECMO explantation, respectively. The other boy treated with venovenous ECMO died of severe hypoxemia and metabolic acidosis. The other girl with VSD, treated with VA ECMO because of failure to wean from cardiopulmonary bypass, died from irreversible heart failure 11 hours after ECMO explantation. The main complications in this series included pulmonary hemorrhage, blood tamponade, surgical site bleeding, hemolysis and hyperbilirubinemia.ConclusionsECMO is an effective therapy for patients with severe heart failure in the perioperative cardiovascular surgery. The keys to successful ECMO are selection of indications, time to set up ECMO, and good management of complications during ECMO.
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影响因子：
4.2
作者：
Ju Zhao;Jinping Liu;Zheng-yi Feng;Shengshou Hu;Yinglong Liu;Xiang-Dong Sheng;Shoujun Li;Xu Wang;C. Long
通讯作者：
Ju Zhao;Jinping Liu;Zheng-yi Feng;Shengshou Hu;Yinglong Liu;Xiang-Dong Sheng;Shoujun Li;Xu Wang;C. Long
影响因子：
5.7
作者：
Chaturvedi, RR;Macrae, D;Goldman, AP
通讯作者：
Goldman, AP
DOI：
--
发表时间：
2006-02
期刊：
Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia
影响因子：
--
作者：
G. Baslaim;J. Bashore;F. Al-Malki;A. Jamjoom
通讯作者：
G. Baslaim;J. Bashore;F. Al-Malki;A. Jamjoom
影响因子：
8.9
作者：
Gajarski, RJ;Mosca, RS;Kulik, TJ
通讯作者：
Kulik, TJ
DOI：
10.1016/0003-4975(95)00410-m
发表时间：
1995-08
期刊：
The Annals of thoracic surgery
影响因子：
--
作者：
Henry Lane Walters;M. Hakimi;M. D. Rice;Juanita M. Lyons;G. Whittlesey;M. Klein
通讯作者：
Henry Lane Walters;M. Hakimi;M. D. Rice;Juanita M. Lyons;G. Whittlesey;M. Klein