Extracorporeal membrane oxygenation with a poly-methylpentene oxygenator (Quadrox D). The experience of a single Italian centre in adult patients with refractory cardiogenic shock
Extracorporeal membrane oxygenation with a poly-methylpentene oxygenator (Quadrox D). The experience of a single Italian centre in adult patients with refractory cardiogenic shock
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DOI：
10.1097/mat.0b013e31815ff27e
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发表时间：
2008-01-01
期刊：
影响因子：
4.2
通讯作者：
Paolini, Giovanni
中科院分区：
文献类型：
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作者：
Formica, Francesco;Avalli, Leonello;Paolini, Giovanni
尽管微孔聚丙烯中空纤维氧合器是用于体外膜氧合（ECMO）的标准装置，但是它们具有局限性，例如血浆泄漏的发展。聚甲基戊烯（PMP）是用于最后一代氧合器的新材料。我们回顾了使用新型PMP氧合器（Quadrox D）和离心泵（RotaFlow）支持难治性心源性休克成人患者的经验。2000年1月至2007年4月期间，25名患者因原发性或心切开术后心源性休克而需要ECMO。分析了18例患者[平均年龄60.2岁; 11例（61%）男性; 7例（39%）女性]。9例患者（50%）发生了原发性心源性休克。11例患者（61%）进行了心脏复苏，平均持续时间为31.5分钟。平均ECMO持续时间为7.1 ± 6.3天（范围：1-27天）。13例患者（72.2%）使用了主动脉内球囊反搏，平均持续时间为7.7 ± 5（范围：2-17天）。12例患者（66.7%）在ECMO下存活，5例患者（27.8%）出院。我们的结果表明，PMP氧合器和离心泵在ECMO和出院时的存活率方面提供了可接受的结果。初始血流动力学状态灾难性的患者可以通过使用PMP氧合器快速建立ECMO获益。
Although microporous polypropylene hollow fiber oxygenators are standard devices used for extracorporeal membrane oxygenation (ECMO), they have limitations such as development of plasma leakage. Poly-methylpentene (PMP) is a new material used for the last generation of oxygenators. We reviewed our experience with a new PMP oxygenator (Quadrox D) and a centrifugal pump (RotaFlow) used to support adult patients with refractory cardiogenic shock. Between January 2000 and April 2007, 25 patients required ECMO for primary or postcardiotomy cardiogenic shock. Eighteen patients were analyzed [mean age 60.2 years; 11 (61 %) men; 7 (39%) women]. Nine patients (50%) suffered primary cardiogenic shock. Cardiopulmonary resuscitation was applied in 11 patients (61 %) with a mean duration time of 31.5 minutes. Mean ECMO duration time was 7.1 +/- 6.3 days (range, 1-27 days). Intra-aortic balloon pump was used in 13 patients (72.2%) with a mean duration time of 7.7 +/- 5 (range, 2-17 days). Twelve patients (66.7%) survived on ECMO and five patients (27.8%) were discharged. Our results indicate the PMP oxygenator and the centrifugal pump provided acceptable results in terms of surviving on ECMO and discharge. Patients with an initial catastrophic hemodynamic status could benefit by means of a rapid institution of ECMO with PMP oxygenators.