Weinhaus L, Canter C, Noetzel M, McAlister W, Spray T L
Division of Pediatric Cardiology, St. Louis Children's Hospital, Washington University Medical Center, Missouri 63110.
Ann Thorac Surg. 1989 Aug;48(2):206-12. doi: 10.1016/0003-4975(89)90071-4.
Extracorporeal membrane oxygenation was used for cardiovascular support in 13 infants and children with complex congenital heart disease and 1 premature neonate treated in preparation for pericardial patch tracheoplasty for long-segment tracheal stenosis. Nine patients were weaned from extracorporeal membrane oxygenation. There were five (36%) early deaths and four (29%) late deaths. Cannulation sites included right carotid/jugular vessels, femoral artery and vein, and right atrium and aorta. In 4 patients, the neck vessels were repaired at decannulation. Five survivors had normal growth and neurodevelopmental evaluations at follow-up. Extracorporeal membrane oxygenation can be successfully used as biventricular support in patients with intractable low cardiac output syndrome after repair of congenital heart disease. Best results are obtained in patients who have several hours of stability after operation before initiation of support. Hemorrhagic complications are reduced and long-term neurodevelopmental outcomes appear promising with right neck vessel cannulation and repair. No bleeding complications were observed in patients cannulated through the neck vessels.
体外膜肺氧合被用于13例患有复杂先天性心脏病的婴幼儿及1例接受准备进行心包补片气管成形术以治疗长段气管狭窄的早产新生儿的心血管支持。9例患者成功脱离体外膜肺氧合。有5例（36%）早期死亡和4例（29%）晚期死亡。插管部位包括右颈动脉/颈静脉、股动脉和股静脉以及右心房和主动脉。4例患者在拔管时修复颈部血管。5名幸存者在随访时生长和神经发育评估正常。体外膜肺氧合可成功用作先天性心脏病修复术后难治性低心排血量综合征患者的双心室支持。在术后开始支持前有几小时稳定期的患者中可获得最佳结果。采用右颈部血管插管和修复可减少出血并发症，且长期神经发育结果似乎很有前景。通过颈部血管插管的患者未观察到出血并发症。
