Allibhai Taslim F, Spinella Philip C, Meyer Michael T, Hall Brian H, Kofos Daniel, DiGeronimo Robert J
Department of Pediatrics, Wilford Hall USAF Medical Center, Lackland AFB, San Antonio, TX 78236-5300, USA.
J Pediatr Surg. 2008 Aug;43(8):e9-e11. doi: 10.1016/j.jpedsurg.2008.03.065.
Adenoviral pneumonia can cause significant pulmonary morbidity leading to extracorporeal membrane oxygenation (ECMO) rescue. Reported survival of adenoviral pneumonia requiring ECMO has been poor, and prolonged time on ECMO is associated with increased mortality. We present 2 pediatric cases of adenoviral pneumonia in patients who survived after greater than 30 days on ECMO and review the Extracorporeal Life Support Organization (ELSO) registry to describe the collective experience of children with viral pneumonia requiring prolonged ECMO. Although survival has improved over the past decade for pediatric adenoviral pneumonia, the ELSO database previously has had no surviving children reported with a primary diagnosis of adenovirus after more than 4 weeks on ECMO. Our experience suggests that there may be use for prolonged ECMO support in children despite severe adenoviral pneumonia.
腺病毒肺炎可导致严重的肺部疾病,进而需要体外膜肺氧合(ECMO)进行抢救。据报道,需要ECMO支持的腺病毒肺炎患者生存率较低,且ECMO使用时间延长与死亡率增加相关。我们报告了2例儿童腺病毒肺炎患者,他们在接受ECMO治疗超过30天后存活,并回顾了体外生命支持组织(ELSO)登记处的数据,以描述需要长时间ECMO支持的病毒性肺炎儿童的总体情况。尽管在过去十年中,儿童腺病毒肺炎的生存率有所提高,但ELSO数据库此前尚无关于ECMO治疗超过4周后以腺病毒为主要诊断且存活的儿童的报道。我们的经验表明,尽管存在严重的腺病毒肺炎,ECMO对儿童的长时间支持仍可能有用。