Clinical Outcomes and Experience of 20 Pediatric Patients Treated with Extracorporeal Membrane Oxygenation in Fuwai Hospital
Clinical Outcomes and Experience of 20 Pediatric Patients Treated with Extracorporeal Membrane Oxygenation in Fuwai Hospital
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DOI：
10.1097/mat.0b013e318172b445
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发表时间：
2008-05
期刊：
影响因子：
4.2
通讯作者：
Ju Zhao;Jinping Liu;Zheng-yi Feng;Shengshou Hu;Yinglong Liu;Xiang-Dong Sheng;Shoujun Li;Xu Wang;C. Long
中科院分区：
文献类型：
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作者：
Ju Zhao;Jinping Liu;Zheng-yi Feng;Shengshou Hu;Yinglong Liu;Xiang-Dong Sheng;Shoujun Li;Xu Wang;C. Long
本研究的目的是回顾性报告20例连续的小儿体外膜肺氧合（ECMO）患者的总结临床结果，并研究与死亡率相关的因素。使用肝素涂层技术完全覆盖ECMO回路系统，所有患者均使用静脉动脉ECMO。肝素剂量为4-20 U/kg/h，活性凝血时间维持在146 - 360秒之间。15例患者（75%）成功撤机; 11例（73%）存活出院; 4例死于术后并发症; 5例撤机失败。在该队列研究中，出院患者的百分比为55%（11/20）。存活患者ECMO前动脉血乳酸浓度显著低于死亡患者（p = 0.009）;两组患者体重差异也有统计学意义（p = 0.046）。ECMO可有效治疗复杂先天性心脏病心脏手术继发的心肺功能衰竭。早期应用ECMO治疗心肺功能衰竭仍是预防重要器官不可逆损伤的关键。
The purpose of this study was to report retrospectively the summarized clinical findings from 20 consecutive pediatric extracorporeal membrane oxygenation (ECMO) patients and to investigate the factors associated with mortality. The ECMO circuit system was completely covered using heparin-coating technique, and venoarterial ECMO was used in all patients. Heparin dosage was 4–20 U/kg/h and active clotting time was maintained between 146 and 360 seconds. ECMO was weaned off successfully in 15 patients (75%); 11 of 15 patients (73%) survived and were discharged from the hospital; 4 of 15 patients died of postoperative complications; 5 patients failed to be weaned off ECMO. The percentage of discharged patients was 55% (11 of 20) in this cohort study. Lactic acid concentration of artery blood before ECMO in survivor patients was significantly lower than in nonsurvivor patients (p = 0.009); patient weight between two groups also had statistical difference (p = 0.046). ECMO effectively treats cardiac and pulmonary failure secondary to cardiac surgeries for complicated congenital heart diseases. Early application of ECMO in patients with cardiac and respiratory failure is still the key point of success in preventing vital organs from irreversible damage.