Gillett D S, Gunning K E, Sawicka E H, Bellingham A J, Ware R J
Br Med J (Clin Res Ed). 1987 Jan 10;294(6564):81-2. doi: 10.1136/bmj.294.6564.81.
A young West Indian woman with established sickle cell disease developed a severe episode of sickle chest syndrome. Conventional treatment including exchange transfusions and mechanical ventilation was to no avail, and an infusion of epoprostenol also failed to halt her worsening condition. When her arterial oxygen tension (PaO2) had fallen to 6.5 kPa (49 mm Hg) extracorporeal membrane oxygenation was instituted. Within two days her PaO2 was greatly improved (maximum 11.6 kPa; 87 mmHg), and by the sixth day pulmonary vascular resistance was reduced and angiography showed reperfusion of many vessels. The patient recovered and six months later showed a transfer factor close to the predicted range and normal spirometric values. Extracorporeal membrane oxygenation should be considered for severe sickle chest syndrome when conventional methods of artificial ventilation fail.
一名患有镰状细胞病的年轻西印度女性出现了严重的镰状胸综合征发作。包括换血输血和机械通气在内的常规治疗均无效，输注依前列醇也未能阻止她病情的恶化。当她的动脉血氧分压（PaO2）降至6.5千帕（49毫米汞柱）时，开始进行体外膜肺氧合。两天内她的PaO2有了显著改善（最高达11.6千帕；87毫米汞柱），到第六天肺血管阻力降低，血管造影显示许多血管再灌注。患者康复，六个月后显示转移因子接近预测范围，肺功能测定值正常。当传统的人工通气方法失败时，对于严重的镰状胸综合征应考虑进行体外膜肺氧合。
