Nagaya M, Tsuda M, Murahashi O, Kishida Y
Department of Pediatric Surgery, Central Hospital, Aichi Prefectural Colony, Kasugai, Japan.
Eur J Pediatr Surg. 1991 Feb;1(1):10-4. doi: 10.1055/s-2008-1042450.
The purpose of this study was to evaluate the efficacy of extracorporeal membrane oxygenation (ECMO) for patients with congenital diaphragmatic hernia (CDH). Ten patients whose mortality was predicted to be more than 80% with previous therapeutics, were selected to use ECMO over the past five years. Patients were placed on ECMO by cannulating the right jugular vein and the right carotid artery. ECMO was started at 34.3 hours after birth on an average, and the average time on ECMO was 96.3 hours. Seven patients (70%) survived, and six out of them are in good health without any sequelae. In particular, all five patients whose pathological condition needing ECMO was persistent fetal circulation (PFC), survived. Therefore we believe ECMO is highly beneficial to overcome the condition of PFC. The survival rate of CDH patients under 24 hours of age in our hospital is 76.2% (16/21 cases) over the last 5 years, and it has improved compared with 57.1% (12/21 cases) before then. The fact that some of the critical patients who were lethal with conventional management, have been successfully treated by ECMO, played a great role in this improvement.
本研究的目的是评估体外膜肺氧合（ECMO）对先天性膈疝（CDH）患者的疗效。在过去五年中，选择了10例经先前治疗预计死亡率超过80%的患者使用ECMO。通过右颈静脉和右颈动脉插管将患者置于ECMO上。ECMO平均在出生后34.3小时开始，平均使用时间为96.3小时。7例患者（70%）存活，其中6例健康状况良好，无任何后遗症。特别是，所有5例因病理状况需要ECMO的持续性胎儿循环（PFC）患者均存活。因此，我们认为ECMO对克服PFC状况非常有益。我院过去5年24小时龄以下CDH患者的存活率为76.2%（16/21例），与之前的57.1%（12/21例）相比有所提高。一些采用传统治疗方法会致命的重症患者通过ECMO成功治疗，这一事实对这一改善起到了很大作用。
