DeBerry Brittany B, Lynch James E, Chernin Jill M, Zwischenberger Joseph B, Chung Dai H
Department of Surgery, The University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555, USA.
Perfusion. 2005 May;20(3):139-43. doi: 10.1191/0267659105pf801oa.
Routine administration of large amounts of pain and sedative medication is common to critically ill pediatric patients undergoing extracorporeal membrane oxygenation (ECMO) for cardiopulmonary failure. It has been our experience that pediatric patients are the most difficult age group in which to achieve an ideal pain and sedative control due to the narrow margin of safety. The purpose of this study was to determine the general practice guideline used for pain and anxiolytic pharmacotherapy for pediatric patients at ECMO centers. We sent a survey questionnaire to all ECMO centers in the USA that treat pediatric respiratory failure patients. Of the 46 responding centers (including telephone follow-ups), 37 (80%) centers had an active pediatric ECMO programs for patients with severe respiratory failure. Fentanyl was the most commonly used pain medication and continuous infusion, administered directly to the patient, was preferred. Subjective effectiveness of various pharmacological agents was variable without clear consensus; however, midazolam was considered to be the most effective agent used.
对于因心肺功能衰竭而接受体外膜肺氧合（ECMO）治疗的危重症儿科患者，常规给予大量止痛和镇静药物是很常见的。根据我们的经验，由于安全范围较窄，儿科患者是最难实现理想的疼痛和镇静控制的年龄组。本研究的目的是确定ECMO中心用于儿科患者疼痛和抗焦虑药物治疗的一般实践指南。我们向美国所有治疗儿科呼吸衰竭患者的ECMO中心发送了调查问卷。在46个回复中心（包括电话随访）中，37个（80%）中心有针对严重呼吸衰竭患者的活跃儿科ECMO项目。芬太尼是最常用的止痛药物，直接给予患者的持续输注是首选给药方式。各种药物的主观疗效各不相同，没有明确的共识；然而，咪达唑仑被认为是最有效的药物。
