Barbaro Ryan P, Paden Matthew L, Guner Yigit S, Raman Lakshmi, Ryerson Lindsay M, Alexander Peta, Nasr Viviane G, Bembea Melania M, Rycus Peter T, Thiagarajan Ravi R
From the *Department of Pediatrics, C.S. Mott Children's Hospital, Ann Arbor, Michigan; †Department of Pediatrics, School of Medicine, Emory University, Atlanta, Georgia; ‡Department of Surgery, University of California Irvine Medical Center, Irvine, California; §Department of Pediatrics, University of Texas Southwestern, Dallas, Texas; ¶Department of Pediatrics, Stollery Children's Hospital, Edmonton, Alberta, Canada; ‖Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts; #Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts; **Department of Anesthesiology and Critical Care Medicine, John Hopkins University, Baltimore, Maryland; and ††Extracorporeal Life Support Organization, Ann Arbor, Michigan.
ASAIO J. 2017 Jul/Aug;63(4):456-463. doi: 10.1097/MAT.0000000000000603.
The purpose of this report is to describe the international growth, outcomes, complications, and technology used in pediatric extracorporeal life support (ECLS) from 2009 to 2015 as reported by participating centers in the Extracorporeal Life Support Organization (ELSO). To date, there are 59,969 children who have received ECLS in the ELSO Registry; among those, 21,907 received ECLS since 2009 with an overall survival to hospital discharge rate of 61%. In 2009, 2,409 ECLS cases were performed at 157 centers. By 2015, that number grew to 2,992 cases in 227 centers, reflecting a 24% increase in patients and 55% growth in centers. ECLS delivered to neonates (0-28 days) for respiratory support was the largest subcategory of ECLS among children <18-years old. Overall, 48% of ECLS was delivered for respiratory support and 52% was for cardiac support or extracorporeal life support to support cardiopulmonary resuscitation (ECPR). During the study period, over half of children were supported on ECLS with centrifugal pumps (51%) and polymethylpentene oxygenators (52%). Adverse events including neurologic events were common during ECLS, a fact that underscores the opportunity and need to promote quality improvement work.
本报告旨在描述体外生命支持组织（ELSO）参与中心所报告的2009年至2015年期间儿科体外生命支持（ECLS）的国际发展情况、治疗结果、并发症及所使用的技术。截至目前，ELSO登记处已有59969名儿童接受了ECLS治疗；其中，自2009年以来有21907名儿童接受了ECLS治疗，总体出院生存率为61%。2009年，157个中心共进行了2409例ECLS治疗。到2015年，这一数字在227个中心增至2992例，患者数量增加了24%，中心数量增长了55%。为新生儿（0 - 28天）提供呼吸支持的ECLS是18岁以下儿童中最大的ECLS亚类。总体而言，48%的ECLS用于呼吸支持，52%用于心脏支持或用于支持心肺复苏的体外生命支持（ECPR）。在研究期间，超过一半的儿童使用离心泵（51%）和聚甲基戊烯氧合器（52%）进行ECLS支持。包括神经系统事件在内的不良事件在ECLS期间很常见，这一事实凸显了促进质量改进工作的机会和必要性。
