Ghez Olivier, Fouilloux Virginie, Charpentier Arnaud, Fesquet Patrick, Lion Frederic, Lebrun Lionel, Commandeur Magali, Fraisse Alain, Metras Dominique, Kreitmann Bernard
Department of Thoracic and Cardiovascular Surgery, Children's Hospital La Timone, Marseille, France.
ASAIO J. 2007 Nov-Dec;53(6):692-5. doi: 10.1097/MAT.0b013e318151412f.
We evaluated the results of using extracorporeal membrane oxygenation (ECMO) as resuscitation for cardiac patients undergoing cardiopulmonary resuscitation (CPR) in our setting where neither perfusionists nor surgeons are always on site, and no circuit may be ready. Between 2003 and 2006, we used ECMO for all cardiac patients who underwent cardiac arrest in the pediatric intensive care unit (PICU) or Cath Laboratory. We reviewed retrospectively 14 consecutive files (15 episodes). Mean CPR time before ECMO institution was 44 minutes (10-110 minutes). The surgeons, perfusionist, and scrub nurse, not on site for three of these patients, had to be called in simultaneously with institution of CPR. Two died on ECMO, the third one was successfully transplanted after 5 days. Globally, 10 patients could be weaned (66%). Eight patients (57%) survived to hospital discharge, seven without obvious neurological damage. One patient was bridged to a left ventricular assist device (LVAD) and was eventually successfully transplanted. He had an ischemic brain lesion with good recuperation and no sequel. We obtained good results with resuscitation ECMO in our setting where a permanently on-site rapid deployment ECMO team is not present at all times.
在我们的医疗环境中，灌注师和外科医生并非随时都在现场，且没有随时可用的体外膜肺氧合（ECMO）设备，我们评估了将ECMO用于接受心肺复苏（CPR）的心脏病患者进行复苏的效果。在2003年至2006年期间，我们对所有在儿科重症监护病房（PICU）或心导管实验室发生心脏骤停的心脏病患者使用了ECMO。我们回顾性分析了连续14份病历（共15次事件）。开始使用ECMO前的平均CPR时间为44分钟（10 - 110分钟）。其中3例患者在CPR开始时，现场没有外科医生、灌注师和洗手护士，必须在开始CPR的同时将他们召集过来。2例患者在使用ECMO期间死亡，第3例患者在5天后成功接受了移植手术。总体而言，10例患者成功撤机（66%）。8例患者（57%）存活至出院，其中7例没有明显的神经损伤。1例患者过渡到左心室辅助装置（LVAD），最终成功接受了移植手术。他有缺血性脑损伤，但恢复良好，没有后遗症。在我们这种并非随时都有随时可快速部署的ECMO团队的医疗环境中，使用ECMO进行复苏取得了良好的效果。
