Vargas-Camacho Gerardo, Contreras-Cepeda Verónica, Gómez-Gutierrez Rene, Quezada-Valenzuela Guillermo, Nieto-Sanjuanero Adriana, Santos-Guzmán Jesús, González-Salazar Francisco
Pediatric Intensive Care Unit, Christus Muguerza High Specialty Hospital, Monterrey, Mexico.
School of Medicine, Tecnologico of Monterrey, Monterrey, Mexico.
SAGE Open Med. 2020 Feb 28;8:2050312120910353. doi: 10.1177/2050312120910353. eCollection 2020.
Extracorporeal membrane oxygenation is a life support procedure developed to offer cardiorespiratory support when conventional therapies have failed. The purpose of this study is to describe the findings during the first years using venoarterial extracorporeal membrane oxygenation in pediatric patients after cardiovascular surgery at Christus Muguerza High Specialty Hospital in Monterrey, Mexico.
This is a retrospective, observational, and descriptive study. The files of congenital heart surgery post-operative pediatric patients, who were treated with venoarterial extracorporeal membrane oxygenation from January 2013 to December 2015, were reviewed.
A total of 11 patients were reviewed, of which 7 (63.8%) were neonates and 4 (36.7%) were in pediatric age. The most common diagnoses were transposition of great vessels, pulmonary stenosis, and tetralogy of Fallot. Survival rate was 54.5% and average life span was 6.3 days; the main complications were sepsis (36.3%), acute renal failure (36.3%), and severe cerebral hemorrhage (9.1%). The main causes of death were multi-organ dysfunction syndrome (27.3%) and cerebral hemorrhage (18.2%).
The mortality rates found are very similar to those found in a meta-analysis report published in 2013 and the main complication and causes of death are also very similar to the majority of extracorporeal membrane oxygenation reports for these kinds of patients. Although the results are encouraging, early sepsis detection, prevention of cerebral hemorrhage, and renal function monitoring must be improved.
体外膜肺氧合是一种在传统治疗方法失败时提供心肺支持的生命支持程序。本研究的目的是描述墨西哥蒙特雷克里斯图斯·穆盖尔扎高级专科医院对心血管手术后儿科患者使用静脉-动脉体外膜肺氧合的最初几年中的研究结果。
这是一项回顾性、观察性和描述性研究。回顾了2013年1月至2015年12月期间接受静脉-动脉体外膜肺氧合治疗的先天性心脏病手术后儿科患者的病历。
共回顾了11例患者,其中7例(63.8%)为新生儿,4例(36.7%)为儿童。最常见的诊断是大动脉转位、肺动脉狭窄和法洛四联症。生存率为54.5%,平均生存期为6.3天;主要并发症为败血症(36.3%)、急性肾衰竭(36.3%)和严重脑出血(9.1%)。主要死亡原因是多器官功能障碍综合征(27.3%)和脑出血(18.2%)。
所发现的死亡率与2013年发表的一项荟萃分析报告中的死亡率非常相似,主要并发症和死亡原因也与这类患者的大多数体外膜肺氧合报告非常相似。尽管结果令人鼓舞,但仍必须改进早期败血症检测、脑出血预防和肾功能监测。