Haines Nikkole M, Rycus Peter T, Zwischenberger Joseph B, Bartlett Robert H, Undar Akif
Pediatric Cardiac Research Laboratory, Department of Pediatrics, Penn State Milton S. Hershey Medical Center, Penn State College Medicine, Penn State Hershey Children's Hospital, Hershey, Pennsylvania 17033-0850, USA.
ASAIO J. 2009 Jan-Feb;55(1):111-6. doi: 10.1097/MAT.0b013e318190b6f7.
Each year thousands of patients require extracorporeal life support (ECLS) for a variety of respiratory, cardiac, and emergency reasons. The ECLS registry, a Federal Drug Administration approved control group, provides a database of approximately 37,000 ECLS patients from domestic and international hospitals, with details about demographic factors, diagnosis, treatment, and complications. The report is circulated to Extracorporeal Life Support Organization members with the goal of providing feedback on each center's practices relative to the performance of all of the centers, and to the general public with the goal of enhancing research and improving patient care. In this report, the ECLS Registry Report International Summary for July 2008 is analyzed with a specific focus on neonatal and pediatric cardiac patients. From the data, it is evident that cardiac ECLS patients have a lower chance of survival than respiratory ECLS patients, and furthermore, younger patients have a lower chance of survival. Requirement for inotropes while on ECLS is by far the most common complication, followed by surgical site bleeding, necessitating hemofiltration. The major mechanical complications facing cardiac ECLS patients are oxygenator failure and clots in the circuit. Databases such as this one provide powerful tools for institutions, clinicians, and researchers.
每年都有成千上万的患者因各种呼吸、心脏和紧急情况需要体外生命支持(ECLS)。ECLS登记处是一个经美国食品药品监督管理局批准的对照组,提供了一个包含来自国内外医院约37000名ECLS患者的数据库,其中详细记录了人口统计学因素、诊断、治疗和并发症等信息。该报告分发给体外生命支持组织的成员,目的是就每个中心相对于所有中心表现的做法提供反馈,同时也向公众发布,目的是加强研究并改善患者护理。在本报告中,对《2008年7月ECLS登记处国际总结报告》进行了分析,特别关注新生儿和小儿心脏患者。从数据中可以明显看出,心脏ECLS患者的存活几率低于呼吸ECLS患者,而且,年龄较小的患者存活几率更低。在接受ECLS治疗期间使用血管活性药物是迄今为止最常见的并发症,其次是手术部位出血,需要进行血液滤过。心脏ECLS患者面临的主要机械并发症是氧合器故障和回路中的血栓。这样的数据库为机构、临床医生和研究人员提供了强大的工具。