Lee Ok Jeong, Cho Yang Hyun, Hwang Jinwook, Yoon Inae, Kim Young-Ho, Cho Joongbum
Department of Pediatrics, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, Changwon, Korea.
Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Acute Crit Care. 2019 Aug;34(3):223-227. doi: 10.4266/acc.2016.00472. Epub 2017 Feb 10.
Managing acute respiratory distress syndrome (ARDS) after severe blunt traumatic lung injury can be challenging. In cases where patients are refractory to conventional therapy, extracorporeal membrane oxygenation (ECMO) should be considered. In addition, the heparin-coated circuit can reduce hemorrhagic complications in patients with multiple traumas. Although prolonged ECMO may be necessary, excellent outcomes are frequently associated. In this study, we report long-term support with venovenous-ECMO applied in a child with severe blunt trauma in Korea. This 10-year-old and 30 kg male with severe blunt thoracic trauma after a car accident developed severe ARDS a few days later, and ECMO was administered for 33 days. Because of pulmonary hemorrhage during ECMO support, heparin was stopped for 3 days and then restarted. He was weaned from ECMO successfully and has been able to run without difficulty for the 2 years since discharge.
管理严重钝性创伤性肺损伤后的急性呼吸窘迫综合征（ARDS）具有挑战性。在患者对传统治疗无效的情况下，应考虑体外膜肺氧合（ECMO）。此外，肝素涂层回路可减少多发伤患者的出血并发症。尽管可能需要长时间使用ECMO，但通常会有良好的预后。在本研究中，我们报告了在韩国一名严重钝性创伤儿童中应用静脉-静脉ECMO进行长期支持的情况。这名10岁、体重30公斤的男性在车祸后发生严重钝性胸部创伤，几天后发展为严重ARDS，并接受了33天的ECMO治疗。由于ECMO支持期间发生肺出血，肝素停用了3天，然后重新开始使用。他成功撤机，出院后2年来能够毫无困难地跑步。
