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拉丁美洲发展中国家的新生儿和儿童体外膜肺氧合

Neonatal and pediatric extracorporeal membrane oxygenation in developing Latin American countries.

作者信息

Kattan Javier, González Álvaro, Castillo Andrés, Caneo Luiz Fernando

机构信息

Pontificia Universidad Católica de Chile, Escuela de Medicina, Departamento de Neonatología, Santiago, Chile.

Pontificia Universidad Católica de Chile, Escuela de Medicina, Departamento de Neonatología, Santiago, Chile.

出版信息

J Pediatr (Rio J). 2017 Mar-Apr;93(2):120-129. doi: 10.1016/j.jped.2016.10.004. Epub 2016 Dec 26.

Abstract

OBJECTIVE

To review the principles of neonatal-pediatric extracorporeal membrane oxygenation therapy, prognosis, and its establishment in limited resource-limited countries in Latino America.

SOURCES

The PubMed database was explored from 1985 up to the present, selecting from highly-indexed and leading Latin American journals, and Extracorporeal Life Support Organization reports.

SUMMARY OF THE FINDINGS

Extracorporeal membrane oxygenation provides "time" for pulmonary and cardiac rest and for recovery. It is used in the neonatal-pediatric field as a rescue therapy for more than 1300 patients with respiratory failure and around 1000 patients with cardiac diseases per year. The best results in short- and long-term survival are among patients with isolated respiratory diseases, currently established as a standard therapy in referral centers for high-risk patients. The first neonatal/pediatric extracorporeal membrane oxygenation Program in Latin America was established in Chile in 2003, which was also the first program in Latin America to affiliate with the Extracorporeal Life Support Organization. New extracorporeal membrane oxygenation programs have been developed in recent years in referral centers in Argentina, Colombia, Brazil, Mexico, Perú, Costa Rica, and Chile, which are currently funding the Latin American Extracorporeal Life Support Organization chapter.

CONCLUSIONS

The best results in short- and long-term survival are in patients with isolated respiratory diseases. Today extracorporeal membrane oxygenation therapy is a standard therapy in some Latin American referral centers. It is hoped that these new extracorporeal membrane oxygenation centers will have a positive impact on the survival of newborns and children with respiratory or cardiac failure, and that they will be available for an increasing number of patients from this region in the near future.

摘要

目的

回顾新生儿 - 儿科体外膜肺氧合治疗的原则、预后情况以及该治疗在拉丁美洲资源有限国家的开展情况。

资料来源

检索了1985年至今的PubMed数据库,选取了高影响力和主要的拉丁美洲期刊以及体外生命支持组织的报告。

研究结果总结

体外膜肺氧合为肺部和心脏的休息及恢复提供了“时间”。在新生儿 - 儿科领域,它作为一种抢救疗法,每年用于治疗超过1300例呼吸衰竭患者和大约1000例心脏病患者。短期和长期生存最佳结果见于孤立性呼吸系统疾病患者,目前在高危患者转诊中心已成为标准疗法。拉丁美洲首个新生儿/儿科体外膜肺氧合项目于2003年在智利设立,这也是拉丁美洲首个加入体外生命支持组织的项目。近年来,阿根廷、哥伦比亚、巴西、墨西哥、秘鲁、哥斯达黎加和智利的转诊中心开展了新的体外膜肺氧合项目,这些中心目前为拉丁美洲体外生命支持组织分会提供资金支持。

结论

短期和长期生存最佳结果见于孤立性呼吸系统疾病患者。如今,体外膜肺氧合治疗在一些拉丁美洲转诊中心已成为标准疗法。希望这些新的体外膜肺氧合中心将对呼吸或心力衰竭的新生儿和儿童的生存产生积极影响,并且在不久的将来能为该地区越来越多的患者所用。

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