Evans M J, Keeling J W
Department of Paediatric Pathology Royal Hospital for Sick Children Edinburgh EH9 1LF, UK.
Arch Dis Child Fetal Neonatal Ed. 1999 Jul;81(1):F30-4. doi: 10.1136/fn.81.1.f30.
To study the cardiac pathology of infants enrolled in the UK collaborative trial of neonatal ECMO (extra corporeal membrane oxygen) who died following random allocation to a trial arm.
During the trial, 81 infants died. The hearts of 26 babies were received and examined without knowledge of treatment regimen. The control group consisted of 14 infants who received conventional treatment. Twelve were allocated to ECMO; seven received this treatment.
In the control group, four showed minor histological changes. The other hearts were histologically normal. In the group treated with ECMO, four had multiple foci of micro-infarction throughout both ventricles and papillary muscles. There was variable thrombotic vascular occlusion. Three were normal. There was no correlation between cardiac pathology and clinical features. There was a significant difference in the length of survival between the two groups.
ECMO treatment seems to be associated with clinically significant cardiac pathology. The changes observed may reflect the longevity of survival in the ECMO group rather than an association with the treatment itself. Nevertheless, the findings have significant implications for those monitoring the development of infants surviving ECMO treatment and suggest that the monitoring of myocardial function will be crucial.
研究在英国新生儿体外膜肺氧合（ECMO）协作试验中，随机分配至试验组后死亡的婴儿的心脏病理学情况。
在试验期间，81名婴儿死亡。接收了26名婴儿的心脏并进行检查，检查时不知其治疗方案。对照组由14名接受常规治疗的婴儿组成。12名被分配至ECMO组；7名接受了该治疗。
在对照组中，4名显示轻微组织学改变。其他心脏组织学正常。在接受ECMO治疗的组中，4名在两个心室和乳头肌有多处微梗死灶。有不同程度的血栓性血管闭塞。3名正常。心脏病理学与临床特征之间无相关性。两组之间的生存时间有显著差异。
ECMO治疗似乎与具有临床意义的心脏病理学情况相关。观察到的改变可能反映了ECMO组的生存时长，而非与治疗本身相关。然而，这些发现对于监测接受ECMO治疗存活婴儿的发育情况具有重要意义，并表明心肌功能监测至关重要。
