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首页> 外文期刊>Artificial Organs >Extracorporeal cardiopulmonary resuscitation in children after open heart surgery
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Extracorporeal cardiopulmonary resuscitation in children after open heart surgery

机译：露天手术后儿童体外心肺重新刺除

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Abstract Extracorporeal membrane oxygenation (ECMO) provides cardiorespiratory support during cardiopulmonary resuscitation unresponsive to conventional methods. Here, we analyzed the extracorporeal cardiopulmonary resuscitation (ECPR) results of children in a cardiac arrest setting after cardiac surgery. Of 3119 cases of pediatric open‐heart surgery, 31 required postoperative ECMO. Among the 31 patients, 11 experienced cardiac arrest and ECPR in the early postoperative period. These 11 patients’ median age is 1.5 [range, 0.1‐19] months and median weight is 3.9 [range, 2.9‐10.3] kg. The medical records of ECPR cases were analyzed. The median ECMO‐assisted time was 68 (range, 13‐456) hours and 4 cases (36.4%) survived. The ECMO‐assisted times were ≤2?days in 4 patients (all eventually died), ≥6?days in 3 patients (all also died), and all 4 cases supported for 2‐6?days were discharged successfully ( P ?=?0.006). In the survivors and nonsurvivors, peak lactate levels were 10.8?±?7.04 and 22.8?±?6.98?mmol/L ( P ?=?0.023) and peak creatinine levels were 47.50?±?25.9 and 153.7?±?73.9?mg/dL ( P ?=?0.035), respectively. In these 11 ECPR cases, the most common complications were bleeding requiring re‐exploration ( n ?=?6, 54.5%) and renal failure ( n ?=?6, 54.5%). The incidence of renal failure was significantly correlated with hypoperfusion time ( P ?=?0.015). ECPR is valuable in children with postoperative cardiac arrest. The higher peak lactate level, higher peak creatinine level, and prolonged ECMO duration were associated with higher mortality. Early diagnosis and intervention of residual anatomical problems could improve survival. Bleeding and renal failure were the most common complications and the incidence of renal failure may be correlated with longer hypoperfusion duration.
机译：摘要体外膜氧合（ECMO）为常规方法无响应有响应的心肺复苏期间提供心肺载体。在这里，我们分析了心脏手术后心脏骤停环境中儿童的体外心肺复苏（ECPR）结果。 3119例儿科露天手术，31例术后ECMO。在31例患者中，在术后早期的11例经验丰富的心脏骤停和ECPR。这11名患者的中位年龄为1.5 [范围，0.1-19]个月，中位数为3.9 [范围，2.9-10.3]千克。分析了ECPR病例的病程。中位ECMO辅助时间为68（范围，13-456）小时，4例（36.4％）存活下来。 ECMO辅助时间≤2患者（最终死亡），≥6岁（所有也死），≥6天（也死亡），所有4例都有2-6个？天数成功出院（P？= ？0.006）。在幸存者和非尿vivers中，峰值乳酸水平为10.8？±7.04和22.8？±6.98？mmol / L（p？= 0.023）和峰肌酐水平为47.50？±25.9和153.7？±73.9？mg / dl（p？= 0.035）。在这11例ECPR病例中，最常见的并发症是出血，需要重新探索（N？= 6,54.5％）和肾功能衰竭（N？=？6,54.5％）。肾功能衰竭的发生率与低血量灌注时间明显相关（P？= 0.015）。 ECPR在术后心脏骤停的儿童中是有价值的。较高的乳酸水平，较高的肌酐水平，延长的ECMO持续时间较高，死亡率较高。剩余解剖问题的早期诊断和干预可以改善存活。出血和肾功能衰竭是最常见的并发症，肾功能衰竭的发生率可能与较长的低渗持续时间相关。

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