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日本小儿体外循环灌注:2010年实践调查。

Pediatric perfusion in Japan: 2010 practice survey.

作者信息

Itoh H, Sano S, Pouard P

机构信息

Department of Cardiovascular Surgery, Okayama University Hospital, Okayama, Japan.

出版信息

Perfusion. 2012 Jan;27(1):72-7. doi: 10.1177/0267659111424638. Epub 2011 Oct 17.

Abstract

We report here Japan's first pediatric perfusion survey. It covers practices from January 2007 through December 2009. Of the 70 congenital heart centers contacted, 53 (76%) completed the survey. They reported performing 3,379 pediatric cardiopulmonary bypass (CPB) procedures in 2009, 3,408 in 2008, and 3,358 in 2007.Twenty-eight percent of all centers used CPB circuits with a priming volume between 151-200 ml. All centers used pre-bypass ultrafiltration and only 6% used retrograde autologous priming. A biomaterial-coated circuit was used by 78% of the centers, a roller pump as the arterial pump by 91%, vacuum-assisted venous drainage by 39%, dilutional ultrafiltration by 48%, and modified ultrafiltration at the end of the procedure by 30%. A regional oxygen saturation monitor was used by 69% of the centers and high flow (150-200 ml/kg/min) management with alpha-stat blood gas control was standard during moderate to normothermic CPBs. Crystalloid cardioplegia solution was used as myocardial protection by 56% of the centers, electronic recording of monitoring data by 51%. The centers performed 98 pediatric extracorporeal membrane oxygenation procedures in 2007, 109 in 2008, and 119 in 2009; 58% of the centers used a centrifugal pump. This survey provides a description of the current practice in Japan. Future surveys will identify trends and rate of change in practice.

摘要

我们在此报告日本首次儿科灌注调查。该调查涵盖了2007年1月至2009年12月期间的相关操作。在联系的70个先天性心脏病中心中,53个(76%)完成了调查。他们报告2009年进行了3379例儿科体外循环(CPB)手术,2008年为3408例,2007年为3358例。所有中心的28%使用预充量在151 - 200毫升之间的CPB回路。所有中心都使用体外循环前超滤,只有6%使用逆行自体预充。78%的中心使用生物材料涂层回路,91%使用滚压泵作为动脉泵,39%使用真空辅助静脉引流,48%使用稀释性超滤,30%在手术结束时使用改良超滤。69%的中心使用区域血氧饱和度监测仪,在中度至常温CPB期间,采用α稳态血气控制的高流量(150 - 200毫升/千克/分钟)管理是标准操作。56%的中心使用晶体心脏停搏液作为心肌保护,51%对监测数据进行电子记录。这些中心在2007年进行了98例儿科体外膜肺氧合手术,2008年为109例,2009年为119例;58%的中心使用离心泵。本次调查描述了日本目前的实践情况。未来的调查将确定实践中的趋势和变化率。

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