Dohain Ahmed M, Abdelmohsen Gaser, Elassal Ahmed A, ElMahrouk Ahmed F, Al-Radi Osman O
Pediatric Cardiology Division, Department of Pediatrics, King Abdulaziz University, Jeddah, Saudi Arabia.
Pediatric Cardiology Division, Department of Pediatrics, Cairo University, Giza, Egypt.
Cardiol Young. 2019 Dec;29(12):1501-1509. doi: 10.1017/S1047951119002634. Epub 2019 Nov 20.
Extracorporeal membrane oxygenation has been widely used after paediatric cardiac surgery due to increasing complex surgical repairs in neonates and infants having complex CHDs.
We reviewed retrospectively the medical records of all patients with CHD requiring corrective or palliative cardiac surgery at King Abdulaziz University Hospital that needed extracorporeal membrane oxygenation support between November 2015 and November 2018.
The extracorporeal membrane oxygenation population was 30 patients, which represented 4% of 746 children who had cardiac surgery during this period. The patients' age range was from 1 day to 20.33 years, with a median age of 6.5 months. Median weight was 5 kg (range from 2 to 53 kg). Twenty patients were successfully decannulated (66.67%), and 12 patients (40%) were survived to hospital discharge. Patients with biventricular repair tended to have better survival rate compared with those with single ventricle palliation (55.55 versus 16.66%, p-value 0.058). During the first 24 hours of extracorporeal membrane oxygenation support, the flow rate was significantly reduced after 4 hours of extracorporeal membrane oxygenation connection in successfully decannulated patients.
Survival to hospital discharge in patients requiring extracorporeal membrane oxygenation support after paediatric cardiac surgery was better in those who underwent biventricular repair than in those who had univentricular palliation. Capillary leak on extracorporeal membrane oxygenation could be a risk of mortality in patients after paediatric cardiac surgery.
由于新生儿和患有复杂先天性心脏病（CHD）的婴儿的外科修复手术日益复杂，体外膜肺氧合（ECMO）在小儿心脏手术后已被广泛应用。
我们回顾性分析了2015年11月至2018年11月期间在阿卜杜勒阿齐兹国王大学医院接受需要ECMO支持的矫正或姑息性心脏手术的所有CHD患者的病历。
接受ECMO治疗的患者有30例占同期746例接受心脏手术患儿的4%。患者年龄范围为1天至20.33岁，中位年龄为6.5个月。中位体重为5kg（范围为2至53kg）。20例患者成功撤机（66.67%），12例患者（40%）存活至出院。与单心室姑息治疗的患者相比，双心室修复的患者存活率更高（55.55%对16.66%，p值0.058）。在ECMO支持的最初24小时内，成功撤机的患者在ECMO连接4小时后流速显著降低。
小儿心脏手术后需要ECMO支持的患者中，接受双心室修复的患者出院存活率高于接受单心室姑息治疗的患者。小儿心脏手术后患者ECMO期间的毛细血管渗漏可能是死亡风险因素。
