Kim Hongsun, Yang Ji-Hyuk, Cho Yang Hyun, Jun Tae-Gook, Sung Kiick, Han Woosik
Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine.
Korean J Thorac Cardiovasc Surg. 2017 Oct;50(5):317-325. doi: 10.5090/kjtcs.2017.50.5.317. Epub 2017 Oct 5.
Extracorporeal membrane oxygenation (ECMO) has become an important treatment modality in pediatric patients with cardiopulmonary failure, but few studies have been conducted in Korea.
We conducted a retrospective review of pediatric patients younger than 18 years who were placed on ECMO between January 2004 and December 2014 at Samsung Medical Center.
We identified 116 children on ECMO support. The overall rate of successful weaning was 51.7%, and the survival to discharge rate was 37.1%. There were 39, 61, and 16 patients on ECMO for respiratory, cardiac, and extracorporeal cardiopulmonary resuscitation, respectively. The weaning rate in each group was 48.7%, 55.7%, and 43.8%, respectively. The survival rate was 43.6%, 36.1%, and 25.0%, respectively. Sixteen patients on ECMO had functional single ventricle physiology; in this group, the weaning rate was 43.8% and the survival rate was 31.3%. Ten patients were on ECMO as a bridge to transplantation (8 for heart and 2 for lung). In patients with heart transplantation, the rate of survival to transplantation was 50.0%, and the overall rate of survival to discharge was 37.5%.
An increasing trend in pediatric ECMO utilization was observed. The outcomes were favorable considering the early experiences that were included in this study and the limited supply of specialized equipment for pediatric patients.
体外膜肺氧合(ECMO)已成为治疗小儿心肺衰竭的重要手段,但韩国在此方面的研究较少。
我们对2004年1月至2014年12月在三星医疗中心接受ECMO治疗的18岁以下小儿患者进行了回顾性研究。
我们确定了116例接受ECMO支持的儿童。总体成功撤机率为51.7%,出院生存率为37.1%。分别有39例、61例和16例患者因呼吸、心脏和体外心肺复苏接受ECMO治疗。每组的撤机率分别为48.7%、55.7%和43.8%。生存率分别为43.6%、36.1%和25.0%。16例接受ECMO治疗的患者具有功能性单心室生理状态;该组的撤机率为43.8%,生存率为31.3%。10例患者接受ECMO作为移植桥梁(8例心脏移植,2例肺移植)。在心脏移植患者中,移植生存率为50.0%,出院总生存率为37.5%。
观察到小儿ECMO使用呈上升趋势。考虑到本研究纳入的早期经验以及小儿专用设备供应有限,结果是令人满意的。