Sasson Lior, Cohen Ilan, Tamir Akiva, Sternfeld Alona Raucher, Berlowitz Yitzhak, Lenczner Orit, Houri Sion
Department of Cardiothoracic Surgery, Wolfson Medical Center, Holon, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel.
Isr Med Assoc J. 2013 Jan;15(1):13-6.
The use of extracorporeal membrane oxygenation (ECMO) in children after cardiac surgery is well established. ECMO support is becoming an integral tool for cardiopulmonary resuscitation in specified centers.
To review our use of ECMO over a 10 year period.
All children supported with ECMO from 2000 to 2010 were reviewed. Most of these children suffered from cardiac anomalies. The patients were analyzed by age, weight, procedure, RACHS-1 when appropriate, length of support, and outcome.
Sixty-two children were supported with ECMO; their median age was 3 months (range 0-216 months) and median weight 4.3 kg (range 1.9-51 kg). Thirty-four patients (52.3%) needed additional hemofiltration or dialysis due to renal failure. The children requiring ECMO support represented a wide spectrum of cardiac lesions; the most common procedure was arterial switch operation (27.4%, n=17). ECMO was required mainly for failure to separate from the heart-lung machine (n=55). The median duration of ECMO support was 4 days (range 1-14 days); 29 (46.7%) patients were weaned successfully from ECMO during this time period, and 5 of them died during hospitalization, yielding an overall hospital survival rate of 38.7%.
ECMO support has significant survival benefit for patients with post-cardiotomy heart failure. Its early deployment should be considered in cardiopulmonary resuscitation.
心脏手术后在儿童中使用体外膜肺氧合（ECMO）已得到充分确立。在特定中心，ECMO支持正成为心肺复苏的一项重要工具。
回顾我们在10年期间对ECMO的使用情况。
对2000年至2010年期间接受ECMO支持的所有儿童进行回顾。这些儿童大多数患有心脏畸形。根据年龄、体重、手术、适当情况下的RACHS-1评分、支持时间和结局对患者进行分析。
62名儿童接受了ECMO支持；他们的中位年龄为3个月（范围0 - 216个月），中位体重4.3千克（范围1.9 - 51千克）。34名患者（52.3%）因肾衰竭需要额外的血液滤过或透析。需要ECMO支持的儿童代表了广泛的心脏病变；最常见的手术是动脉调转术（27.4%，n = 17）。ECMO主要用于无法脱离心肺机（n = 55）。ECMO支持的中位持续时间为4天（范围1 - 14天）；在此期间，29名（46.7%）患者成功脱离ECMO，其中5名在住院期间死亡，总体住院生存率为38.7%。
ECMO支持对心脏术后心力衰竭患者有显著的生存益处。在心肺复苏中应考虑早期应用。
