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首页> 外文期刊>Pediatric critical care medicine: a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies >Emergent use of extracorporeal membrane oxygenation during pediatric cardiac catheterization.
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Emergent use of extracorporeal membrane oxygenation during pediatric cardiac catheterization.

机译：小儿心脏导管插入术中紧急使用体外膜氧合。

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OBJECTIVES: The goal of this study was to evaluate the utility of extracorporeal membrane oxygenation (ECMO) to resuscitate patients following critical cardiac events in the catheterization laboratory. DESIGN: Retrospective review of medical records. SETTING: Cardiac intensive care unit and cardiac catheterization laboratory at a tertiary care children's hospital. PATIENTS: Pediatric patients cannulated emergently for ECMO in the cardiac catheterization laboratory (n = 22). INTERVENTIONS: ECMO was initiated emergently in the cardiac catheterization laboratory for progressive hemodynamic deterioration due to low cardiac output syndrome or catheter-induced complications. MEASUREMENTS AND MAIN RESULTS: Twenty-two patients were cannulated for ECMO in the catheterization laboratory between 1996 and 2004. Median age was 33 months (range 0-192), median weight 14.8 kg (2.4-75), and median duration of ECMO 84 hrs (2-343). Indications included catheter-induced complication (n = 14), severe low cardiac output syndrome (n = 7), and hypoxemia (n = 1). Three patients (14%) were cannulated in the catheterization laboratory before catheterization for low cardiac output or hypoxemia. During cannulation, 19 patients (86%) were receiving chest compressions; median duration of cardiopulmonary resuscitation was 29 mins (20-57). Eighteen patients (82%) survived to discharge (five of whom underwent cardiac transplantation) and four (18%) died. Of 19 patients who received cardiopulmonary resuscitation during cannulation, 15 (79%) survived to discharge and nine (47%) sustained neurologic injury. There was no significant difference between survivors and nonsurvivors in age, weight, duration of cardiopulmonary resuscitation or ECMO support, pH, or lactate levels. CONCLUSIONS: ECMO is a technically feasible and highly successful tool in the resuscitation of pediatric patients following critical events in the cardiac catheterization laboratory.
机译：目的：本研究的目的是评估在导管实验室发生严重心脏事件后体外膜氧合（ECMO）复苏患者的效用。设计：回顾性病历。地点：三级医疗儿童医院的心脏重症监护室和心脏导管实验室。患者：在心脏导管实验室紧急为ECMO插管的小儿患者（n = 22）。干预措施：ECMO是在心脏导管实验室紧急启动的，用于治疗因低心输出量综合征或导管引起的并发症而导致的血液动力学恶化。测量和主要结果：1996年至2004年间，22名患者在导管实验室接受了ECMO插管。中位年龄为33个月（范围为0-192），中位数体重为14.8千克（2.4-75），中位数为ECMO 84小时（2-343）。适应症包括导管诱发的并发症（n = 14），严重的低心输出量综合征（n = 7）和低氧血症（n = 1）。三名患者（14％）因低心排血量或低氧血症在插管前在插管实验室进行了插管。在插管过程中，有19例患者（86％）受到胸部按压。心肺复苏的中位持续时间为29分钟（20-57）。 18例患者（82％）存活至出院（其中5例接受了心脏移植），4例（18％）死亡。在插管期间接受心肺复苏的19例患者中，有15例（79％）存活至出院，另有9例（47％）遭受了神经系统损伤。幸存者与非幸存者之间的年龄，体重，心肺复苏持续时间或ECMO支持，pH或乳酸水平无显着差异。结论：ECMO是在心脏导管实验室发生严重事件后对儿科患者进行复苏的技术上可行且非常成功的工具。

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