Martin G R, Short B L
Department of Cardiology, Children's Hospital National Medical Center, Washington, DC 20010.
Am J Cardiol. 1988 Nov 1;62(13):929-34. doi: 10.1016/0002-9149(88)90895-8.
Cardiac performance was evaluated by Doppler echocardiography in 19 infants with persistent pulmonary hypertension before, during and after prolonged extracorporeal membrane oxygenation (ECMO). Systemic arterial pressure was normal before ECMO (67 +/- 12 mm Hg), increased during ECMO (78 +/- 13 mm Hg) and decreased to baseline after ECMO (p less than or equal to 0.01). Heart rate was normal before ECMO and did not change during or after ECMO. The left ventricular shortening fraction was normal before ECMO (37 +/- 11%), decreased after beginning ECMO (25 +/- 11%) and returned to baseline 72 hours after beginning ECMO (p less than or equal to 0.01). Pulmonary arterial and aortic blood flow velocities were normal before ECMO, decreased 30 to 50% during ECMO and increased to baseline 72 hours after beginning ECMO (p less than or equal to 0.01). Stroke volume had an identical trend (p less than or equal to 0.01). Left ventricular velocity of circumferential shortening--an index of contractility--decreased after beginning ECMO (p less than or equal to 0.05). Left ventricular systolic wall stress--an index of systemic afterload--increased after beginning ECMO (p less than or equal to 0.01). A patent ductus arteriosus was present in 13 of 19 infants before ECMO, 16 of 19 infants during ECMO and in none of 19 infants after ECMO. Pulmonary arterial systolic pressure was high before ECMO (72 +/- 25 mm Hg), began to decrease after 48 hours on ECMO (59 +/- 24 mm Hg) and was normal after ECMO (38 +/- 18 mm Hg), p less than or equal to 0.05.(ABSTRACT TRUNCATED AT 250 WORDS)
采用多普勒超声心动图对19例持续性肺动脉高压婴儿在长时间体外膜肺氧合（ECMO）治疗前、治疗期间及治疗后的心功能进行评估。ECMO治疗前体动脉压正常（67±12mmHg），治疗期间升高（78±13mmHg），治疗后降至基线水平（p≤0.01）。ECMO治疗前心率正常，治疗期间及治疗后未发生变化。左心室缩短分数在ECMO治疗前正常（37±11%），开始ECMO治疗后降低（25±11%），开始ECMO治疗72小时后恢复至基线水平（p≤0.01）。ECMO治疗前肺动脉和主动脉血流速度正常，治疗期间降低30%至50%，开始ECMO治疗72小时后升至基线水平（p≤0.01）。每搏输出量有相同趋势（p≤0.01）。圆周缩短左心室速度（收缩性指标）开始ECMO治疗后降低（p≤0.05）。左心室收缩壁应力（体循环后负荷指标）开始ECMO治疗后升高（p≤0.01）。19例婴儿中，13例在ECMO治疗前存在动脉导管未闭，16例在ECMO治疗期间存在，19例在ECMO治疗后均未发现。ECMO治疗前肺动脉收缩压较高（72±25mmHg），ECMO治疗48小时后开始下降（59±24mmHg），ECMO治疗后恢复正常（38±18mmHg），p≤0.05。（摘要截短至250字）
