Division of Pediatric Critical Care Medicine, Department of Pediatrics, Duke University Medical Center, Durham, North Carolina 27710, USA.
Respir Care. 2011 Jun;56(6):866-70. doi: 10.4187/respcare.01051. Epub 2011 Feb 11.
We report the first successful use of venovenous extracorporeal membrane oxygenation (ECMO) for refractory respiratory failure in an infant with DiGeorge anomaly, following thymus transplantation. A 23-month-old female with complete immune-incompetent DiGeorge anomaly 65 days after allogenic thymus transplantation was treated in our pediatric intensive care unit for acute respiratory failure secondary to bacterial sepsis. She subsequently developed acute hypercarbic respiratory failure unresponsive to conventional medical therapy. She was successfully managed with venovenous ECMO for 4 days, with complete resolution of her respiratory symptoms. This case demonstrates the complex decision making process regarding initiation of ECMO in patients with severe immunodeficiency.
我们报告了首例在患有 DiGeorge 异常的婴儿中，在进行胸腺移植后，使用静脉-静脉体外膜氧合（ECMO）治疗难治性呼吸衰竭的成功案例。一名 23 个月大的女性，在进行同种异体胸腺移植 65 天后患有完全免疫无能的 DiGeorge 异常，因细菌败血症继发急性呼吸衰竭而在我们的儿科重症监护病房接受治疗。随后，她出现急性高碳酸血症性呼吸衰竭，对常规药物治疗无反应。她成功地接受了静脉-静脉 ECMO 治疗 4 天，呼吸症状完全缓解。该病例展示了在严重免疫缺陷患者中启动 ECMO 的复杂决策过程。
