Li Hong-liang, Meng Chao, Zhu Xi, Guo Li-min, Li Bao-shun
Department of Intensive Care Medicine, Third Hospital, Peking University, Beijing 100191, China.
Zhongguo Wei Zhong Bing Ji Jiu Yi Xue. 2012 Feb;24(2):86-9.
To evaluate the supportive effects on cardiopulmonary failure in critically ill patients treated with extracorporeal membrane oxygenation (ECMO).
A retrospective observational study of 9 patients treated in intensive care unit (ICU) of Peking University Third Hospital and Beijing Ditan Hospital from October 1, 2007 to December 26, 2009 with ECMO for various diseases was conducted. Clinical data was analyzed.
Of 9 patients [mean age (26.8 ± 7.0) years, body mass index (28.3 ± 9.1) kg/m(2)] were enrolled, 3 were male and 6 were female. Two patients were treated with veno-arterial(V-A) ECMO for severe heart failure, and 7 with veno-venous(V-V) ECMO due to refractory acute respiratory distress syndrome ARDS caused by 2009 novel H1N1 virus infection. The doses of vasoactive agents and cardiac parameters changed greatly after the V-A mode. The setting of ventilator support were significantly decreased, and arterial oxygen saturation [SaO(2)], arterial blood carbon dioxide partial pressure [PaCO(2)] and blood pH value were improved significantly after the V-V mode ECMO. Acute renal insufficiency occurred in 5 patients, hyperbilirubinemia in 6 patients, and catheter related blood stream infection in 4 patients. Five patients were weaned from ECMO successfully and 4 of them rehabilitated, the treatment was withdrawn in 2 patients, and the other 2 patients died during the procedure. The mean amount of red blood cell suspension administered per patients was (15.1 ± 9.9) U, and length of ICU stay was (18.9 ± 15.7) days.
ECMO has a rapid effect to temporarily support heart or lung function (partially or totally) during cardiopulmonary failure, leading to organ recovery. Attempts to reduce the incidence of complications might improve the prognosis of critically ill patients.
评估体外膜肺氧合（ECMO）治疗危重症患者心肺功能衰竭的支持效果。
对2007年10月1日至2009年12月26日在北京大学第三医院和北京地坛医院重症监护病房（ICU）因各种疾病接受ECMO治疗的9例患者进行回顾性观察研究。分析临床资料。
纳入的9例患者[平均年龄（26.8±7.0）岁，体重指数（28.3±9.1）kg/m²]中，男性3例，女性6例。2例患者因严重心力衰竭接受静脉-动脉（V-A）ECMO治疗，7例因2009年新型H1N1病毒感染导致的难治性急性呼吸窘迫综合征（ARDS）接受静脉-静脉（V-V）ECMO治疗。V-A模式后血管活性药物剂量和心脏参数变化较大。V-V模式ECMO后呼吸机支持设置显著降低，动脉血氧饱和度[SaO₂]、动脉血二氧化碳分压[PaCO₂]和血液pH值显著改善。5例患者发生急性肾功能不全，6例患者发生高胆红素血症，4例患者发生导管相关血流感染。5例患者成功撤机，其中4例康复，2例患者停止治疗，另外2例患者在治疗过程中死亡。每位患者平均输注红细胞悬液量为（15.1±9.9）U，ICU住院时间为（18.9±15.7）天。
ECMO在心肺功能衰竭期间对暂时支持心脏或肺功能（部分或全部）具有快速效果，可促使器官恢复。尝试降低并发症发生率可能改善危重症患者的预后。
