White Ralph W, Peek Giles J, Jenkins David R, Killer Hilliary M, Firmin Richard K
Heartlink ECMO Centre, Department of Cardiothoracic Surgery, Glenfield Hospital, Leicester, United Kingdom.
ASAIO J. 2003 Jul-Aug;49(4):378-82.
The experience of extracorporeal membrane oxygenation (ECMO) use for severe chickenpox pneumonia was reviewed. Case notes of all patients treated with ECMO for this disease between 1992 and 1997 were reviewed. Of 405 patients referred for ECMO during this period, the diagnosis was chickenpox pneumonia in 14 (3.5%); all 14 were treated with ECMO. The median age of patients was 32.5 years (range 5 to 61 years). The median duration of extracorporeal support was 164 hours (range 45 to 652). Ten of 14 patients (71%) required hemofiltration. Overall survival of patients supported with ECMO was 57% (8 of 14). Deaths were caused by sepsis (5 patients, source identified in 4) and multiorgan failure (1 patient). Pneumonia as a complication of chickenpox can rapidly become severe and life threatening. Extracorporeal respiratory support may be helpful in patients refractory to conventional ventilation.
回顾了体外膜肺氧合(ECMO)用于治疗重症水痘肺炎的经验。对1992年至1997年间所有接受ECMO治疗该疾病的患者病历进行了回顾。在此期间转诊接受ECMO治疗的405例患者中,诊断为水痘肺炎的有14例(3.5%);这14例均接受了ECMO治疗。患者的中位年龄为32.5岁(范围5至61岁)。体外支持的中位持续时间为164小时(范围45至652小时)。14例患者中有10例(71%)需要血液滤过。接受ECMO支持的患者总体生存率为57%(14例中的8例)。死亡原因是败血症(5例,4例确定了感染源)和多器官功能衰竭(1例)。水痘并发症肺炎可迅速发展为重症并危及生命。体外呼吸支持可能对常规通气无效的患者有帮助。