Urbańska Ewa, Grzybowski Adam, Haponiuk Ireneusz, Przybylski Roman, Walas Wojciech, Stempniewicz Krzysztof, Szary Tomasz, Włoczka Grzegorz, Skalski Janusz H, Zembala Marian
Kliniczny Oddział Kardioanestezji, Slaska Akademia Medyczna, ul. Szpitalna 2, 41-800 Zabrze, Poland.
Med Wieku Rozwoj. 2006 Oct-Dec;10(4):1055-65.
THE AIM of the study was to show first results of newborn life threatening respiratory failure treatment with extracorporeal membrane oxygenation (ECMO) in Poland.
Nine newborns were treated with extracorporeal membrane oxygenation in Silesian Center for Heart Diseases. Newborns were born in 38 week of gestational age (36-41 weeks) with mean birth weight of 3490 g. Reasons for the referral were: meconium aspiration syndrome, infection, and pulmonary hypertension. Each newborn fulfilled an Extracorporeal Life Support Organization (ELSO) criteria for extracorporeal membrane oxygenation.
seven out of nine of patients treated with extracorporeal membrane oxygenation survived. Full clinical stabilization was reached about 6th hour of treatment. Mean extracorporeal oxygenation time was 162 hours. For eight newborns veno-venous method was applied and for one newborn veno-arterial method. Roller pump was used in 7 cases and centrifugal pomp in one case. Five newborns had uneventful treatment. During extracorporeal membrane oxygenation therapy we have observed several complications: PDA, hemorrhagic complications, renal failure, arterial hypertension, septicemia, tubing rupture.
extracorporeal oxygenation is an effective method of treatment for newborn life threatening respiratory failure. Obtained results do not differ much from Extracorporeal Life Support Organization register results. The most essential problem for extracorporeal membrane oxygenation therapy is correct qualification, early referral, safe transportation as well as the development of centers providing ECMO treatment.
本研究的目的是展示波兰体外膜肺氧合（ECMO）治疗新生儿危及生命的呼吸衰竭的初步结果。
西里西亚心脏病中心对9名新生儿进行了体外膜肺氧合治疗。新生儿的孕周为38周（36 - 41周），平均出生体重为3490克。转诊原因包括：胎粪吸入综合征、感染和肺动脉高压。每个新生儿均符合体外生命支持组织（ELSO）的体外膜肺氧合标准。
接受体外膜肺氧合治疗的9名患者中有7名存活。治疗约6小时后实现了完全临床稳定。平均体外氧合时间为162小时。8名新生儿采用静脉 - 静脉方法，1名新生儿采用静脉 - 动脉方法。7例使用滚压泵，1例使用离心泵。5名新生儿治疗过程顺利。在体外膜肺氧合治疗期间，我们观察到了几种并发症：动脉导管未闭、出血并发症、肾衰竭、动脉高血压、败血症、管道破裂。
体外氧合是治疗新生儿危及生命的呼吸衰竭的有效方法。获得的结果与体外生命支持组织登记结果差异不大。体外膜肺氧合治疗最关键的问题是正确的评估、早期转诊、安全运输以及提供ECMO治疗的中心的发展。
