Gray Brian W, Haft Jonathan W, Hirsch Jennifer C, Annich Gail M, Hirschl Ronald B, Bartlett Robert H
From the *Departments of Surgery, †Cardiac Surgery, and ‡Pediatrics, University of Michigan, Ann Arbor, Michigan.
ASAIO J. 2015 Jan-Feb;61(1):2-7. doi: 10.1097/MAT.0000000000000150.
This is a review of the University of Michigan experience with extracorporeal life support (ECLS) also known as extracorporeal membrane oxygenation (ECMO). Two thousand patients were managed with ECMO from 1973 to 2010. The first 1,000 patients were reported previously. Of the 2,000 patients, 74% were weaned from ECLS, and 64% survived to hospital discharge. In patients with respiratory failure, survival to hospital discharge was 84% in 799 neonates, 76% in 239 children, and 50% in 353 adults. Survival in patients with cardiac failure was 45% in 361 children and 38% in 119 adults. ECLS during extracorporeal cardiopulmonary resuscitation was performed in 129 patients, with 41% surviving to discharge. Survival decreased from 74 to 55% between the first and second 1,000 patients. The most common complication was bleeding at sites other than the head, with an incidence of 39%, and the least frequent complication was pump malfunction, with a 2% incidence. Intracranial bleeding or infarction occurred in 8% of patients, with a 43% survival rate. This is the largest series of ECLS at one institution reported in the world to date. Our experience has shown that ECLS saves lives of moribund patients with acute pulmonary and cardiac failure in all age groups.
这是一篇关于密歇根大学体外生命支持（ECLS，也称为体外膜肺氧合（ECMO））经验的综述。1973年至2010年期间，有2000例患者接受了ECMO治疗。前1000例患者的情况此前已报道。在这2000例患者中，74%成功脱离ECLS，64%存活至出院。在呼吸衰竭患者中，799例新生儿存活至出院的比例为84%，239例儿童为76%，353例成人为50%。心力衰竭患者中，361例儿童的存活率为45%，119例成人的存活率为38%。129例患者在体外心肺复苏期间接受了ECLS治疗，41%存活至出院。在首批1000例患者和第二批1000例患者之间，存活率从74%降至55%。最常见的并发症是头部以外部位出血，发生率为39%，最不常见的并发症是泵故障，发生率为2%。8%的患者发生颅内出血或梗死，存活率为43%。这是迄今为止世界上报道的单个机构中最大规模的ECLS系列研究。我们的经验表明，ECLS挽救了所有年龄组中患有急性肺和心力衰竭的濒死患者的生命。
