Raithel S C, Swartz M T, Braun P R, Dake S B, Taub J O, Zambie M A, Miller L W, Deligonul U, McBride L R, Pennington D G
Division of Cardiothoracic Surgery, St. Louis University School of Medicine, Missouri.
ASAIO Trans. 1989 Jul-Sep;35(3):475-7. doi: 10.1097/00002480-198907000-00098.
The need for a portable extracorporeal support system that can be rapidly initiated for various types of cardiopulmonary failure is well known. The authors report on a system consisting of 3/8 inch tubing, a Sci-Med membrane oxygenator, Omnitherm heat exchanger, Biomedicus or Sarns centrifugal pump, portable battery, and oxygen tanks. The system is mounted on a cart for easy mobility and can be primed in 5-10 min. USCI, DLP, or Axiom cannulas can be inserted femorally. Over 30 months, 29 patients, aged 19-78 years, underwent extracorporeal membrane oxygenation (ECMO) support for cardiac arrest during catheterization (10 patients), shock secondary to acute myocardial infarction (MI) (10 patients), elective percutaneous transluminal coronary angioplasty (PTCA) support (four patients), postcardiotomy failure (four patients), and exposure hypothermia (one patient). Adequate support was achieved in all but one patient. Device flows ranged from 0.2 to 6.0 l/min. There were six survivors (elective PTCA support, three patients; cardiac arrest during catheterization, three patients). Complications included bleeding (15 patients), deep venous thrombosis (three patients), and pump failure (one patient). A portable ECMO system has been developed that allows rapid institution of circulatory support.
对于一种能够针对各种类型的心肺衰竭迅速启动的便携式体外支持系统的需求是众所周知的。作者报告了一种由3/8英寸管道、Sci-Med膜式氧合器、Omnitherm热交换器、Biomedicus或Sarns离心泵、便携式电池和氧气罐组成的系统。该系统安装在推车上以便于移动，并且可以在5到10分钟内完成预充。可以经股动脉插入USCI、DLP或Axiom插管。在30多个月的时间里，29名年龄在19至78岁之间的患者接受了体外膜肺氧合（ECMO）支持，用于导管插入期间心脏骤停（10例患者）、急性心肌梗死（MI）继发休克（10例患者）、择期经皮腔内冠状动脉成形术（PTCA）支持（4例患者）、心脏手术后衰竭（4例患者）以及暴露性低温（1例患者）。除1例患者外，所有患者均获得了充分的支持。设备流量范围为0.2至6.0升/分钟。有6例幸存者（择期PTCA支持，3例患者；导管插入期间心脏骤停，3例患者）。并发症包括出血（15例患者）、深静脉血栓形成（3例患者）和泵衰竭（1例患者）。已经开发出一种便携式ECMO系统，可实现循环支持的快速建立。
