Erdil Tugba, Lemme Frithjof, Konetzka Alexander, Cavigelli-Brunner Anna, Niesse Oliver, Dave Hitendu, Hasenclever Peter, Hübler Michael, Schweiger Martin
Pediatric Cardiovascular Surgery, Pediatric Heart Center, Department of Surgery, University Children's Hospital Zurich, Zurich, Switzerland.
Children's Research Centre, University of Zurich, Zurich, Switzerland.
Ann Cardiothorac Surg. 2019 Jan;8(1):109-115. doi: 10.21037/acs.2018.09.08.
Extracorporeal membrane oxygenation (ECMO) is a general term that describes the short- or long-term support of the heart and/or lungs in neonates, children and adults. Due to favorable results and a steady decline in absolute contraindications, its use is increasing worldwide. Indications in children differ from those in adults. The ECMO circuit as well as cannulation strategies also are individualized, considering their implications in children. The aim of this article is to review the clinical indications, different circuits, and cannulation strategies for ECMO. We also present our institutional experience with 92 pediatric ECMO patients (34 neonates, 58 pediatric) with the majority (80%) of veno-arterial placements between 2014 until 2018. We further to also highlight ECMO use in the setting of cardiac arrest [extracorporeal cardiopulmonary resuscitation (CPR) or eCPR].
体外膜肺氧合(ECMO)是一个通用术语,用于描述对新生儿、儿童和成人心脏和/或肺部的短期或长期支持。由于取得了良好的效果,且绝对禁忌证稳步减少,其在全球范围内的使用正在增加。儿童的适应证与成人不同。考虑到其对儿童的影响,ECMO回路以及插管策略也都是个性化的。本文旨在综述ECMO的临床适应证、不同回路和插管策略。我们还介绍了我们机构对92例儿科ECMO患者(34例新生儿,58例儿童)的经验,其中大多数(80%)是在2014年至2018年期间进行的静脉-动脉置管。我们还进一步强调了在心脏骤停情况下(体外心肺复苏或eCPR)ECMO的使用。