Department of Pediatrics, Division of Newborn Medicine, Penn State Hershey Pediatric Cardiovascular Research Center, Penn State Hershey College of Medicine, Penn State Hershey Children's Hospital, Hershey, PA, USA.
Artif Organs. 2012 Jul;36(7):607-15. doi: 10.1111/j.1525-1594.2012.01445.x. Epub 2012 May 25.
The objective of this investigation is to describe recent changes made in extracorporeal life support (ECLS) technology in the US Postal survey to directors and coordinators of all 125 US ECLS centers identified by Extracorporeal Life Support Organization as of November 2010, with follow-up of nonrespondents. Spearman coefficients were used to correlate the method of updating knowledge of ECLS technology with the likelihood of changing technology, and to correlate decision-making hierarchy with the likelihood of changing equipment. The response rate was 75% representing 34 states, and the majority of respondents were ECLS coordinators (56.6%). Respiratory diagnosis is the predominant indication for ECLS at any age. Over 40% of centers are using a hollow-fiber oxygenator for neonates and 80% of pediatric patients. Roller pumps are used in 70% of neonatal and pediatric ECLS. Forty-two percent of centers changed the oxygenator type within the past 3 years, while 30% changed both the oxygenator and pump. Less than 10% of centers reported problems with either oxygenator or pump in both neonates and pediatric ECLS. Forty-six percent of respondents that changed oxygenators cited that the primary reason for changing was "clinical preference/experience," while the other half was split between "FDA approval" and "Research results." In 40% of centers, a multidisciplinary group made decisions on changing technology. This survey indicates that over one-half of ECLS centers implemented new technology within the past 3 years. Knowledge of ECLS technology and safe operation of ECLS circuit components is essential in preventing some of the mechanical complications.
本研究旨在描述美国体外生命支持（ECLS）技术的最新变化。通过对截至 2010 年 11 月由体外生命支持组织确认的 125 个美国 ECLS 中心的主任和协调员进行美国邮政调查，并对未回复者进行随访。采用斯皮尔曼系数来关联更新 ECLS 技术知识的方法与改变技术的可能性，以及关联决策层次与改变设备的可能性。回复率为 75%，代表 34 个州，大多数回复者为 ECLS 协调员（56.6%）。呼吸诊断是任何年龄段 ECLS 的主要适应证。超过 40%的中心在新生儿和 80%的儿科患者中使用空心纤维氧合器。滚压泵在 70%的新生儿和儿科 ECLS 中使用。42%的中心在过去 3 年内改变了氧合器类型，而 30%的中心同时改变了氧合器和泵。不到 10%的中心报告在新生儿和儿科 ECLS 中，氧合器或泵都存在问题。46%改变氧合器的中心表示，改变的主要原因是“临床偏好/经验”，而另一半则分为“FDA 批准”和“研究结果”。在 40%的中心，一个多学科小组对改变技术做出决策。这项调查表明，超过一半的 ECLS 中心在过去 3 年内采用了新技术。ECLS 技术的知识和 ECLS 回路组件的安全操作对于预防一些机械并发症至关重要。
