Department of Neonatology, Children's National Medical Center, The George Washington University School of Medicine, 111 Michigan Ave, NW, Washington, DC 20010.
Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA; Medical Director, Neonatal ECMO Program, Lucile Salter Packard Children's Hospital, Palo Alto, CA.
Semin Perinatol. 2014 Mar;38(2):71-7. doi: 10.1053/j.semperi.2013.11.003.
Extracorporeal membrane oxygenation (ECMO) continues to be an important rescue therapy for newborns with a variety of causes of cardio-respiratory failure unresponsive to high-frequency ventilation, surfactant replacement, and inhaled nitric oxide. There are approximately 800 neonatal respiratory ECMO cases reported annually to the Extracorporeal Life Support Organization; venoarterial ECMO has been used in approximately 72% with a cumulative survival of 71% and venovenous has been used in 28% with a survival of 84%. Congenital diaphragmatic hernia is now the most common indication for ECMO. This article reviews the development of the two types of extracorporeal support, venoarterial and venovenous ECMO, and discusses the advantages of each method, the current selection criteria, the procedure, and the clinical management of neonates on ECMO.
体外膜肺氧合（ECMO）仍然是一种重要的抢救疗法，适用于对高频通气、表面活性剂替代和吸入一氧化氮无反应的各种原因导致心肺衰竭的新生儿。据体外生命支持组织每年报告约 800 例新生儿呼吸 ECMO 病例；其中约 72% 使用静脉-动脉 ECMO，累积存活率为 71%，28% 使用静脉-静脉 ECMO，存活率为 84%。先天性膈疝现在是 ECMO 的最常见指征。本文回顾了两种类型的体外支持，静脉-动脉 ECMO 和静脉-静脉 ECMO 的发展，并讨论了每种方法的优点、当前的选择标准、程序以及 ECMO 新生儿的临床管理。
