Duyu Muhterem, Sefer Asena Pınar
Department of Pediatrics, Pediatric Intensive Care Unit, Medeniyet University Göztepe Training and Research Hospital, Istanbul, Turkey.
Department of Pediatrics, Medeniyet University Göztepe Training and Research Hospital, Istanbul, Turkey.
Turk Gogus Kalp Damar Cerrahisi Derg. 2020 Jan 23;28(1):92-100. doi: 10.5606/tgkdc.dergisi.2020.18359. eCollection 2020 Jan.
In this study, we present our experience with bicaval, dual-lumen, venovenous extracorporeal membrane oxygenation in pediatric patients with severe respiratory failure.
Between September 2015 and May 2019, a total of nine pediatric patients (7 males, 2 females; median age 3.1 years; range, 0.3 to 7.4 years) hospitalized in the pediatric intensive care unit due to severe respiratory failure who were cannulated using a bicaval, dual-lumen, venovenous catheter were retrospectively analyzed. Patient demographics, cannulation details, complication of catheter use, and outcomes were recorded.
The median duration of extracorporeal membrane oxygenation support was nine (range, 2 to 32) days. One patient required conversion to venoarterial extracorporeal membrane oxygenation and one patient required conversion to conventional double-cannulated venovenous extracorporeal membrane oxygenation. Of the patients, 33% suffered from bleeding complications. There were no cannula- or circuit-related complications. Adequate oxygenation and flow were obtained in all patients, except one. No mortalities were directly associated with the cannulation strategy used.
The bicaval, dual-lumen cannula can be safely used in pediatric patients with minimal complication rates and is our preferred method for venovenous extracorporeal membrane oxygenation support.
在本研究中，我们介绍了双腔、双腔静脉 - 静脉体外膜肺氧合在小儿严重呼吸衰竭患者中的应用经验。
回顾性分析2015年9月至2019年5月期间，9例因严重呼吸衰竭入住儿科重症监护病房的患儿（7例男性，2例女性；中位年龄3.1岁；范围0.3至7.4岁），这些患儿使用双腔、双腔静脉导管进行插管。记录患者的人口统计学资料、插管细节、导管使用并发症及结局。
体外膜肺氧合支持的中位持续时间为9天（范围2至32天）。1例患者需要转换为静脉 - 动脉体外膜肺氧合，1例患者需要转换为传统的双腔静脉 - 静脉体外膜肺氧合。33%的患者出现出血并发症。未发生与插管或回路相关的并发症。除1例患者外，所有患者均获得了足够的氧合和血流量。没有死亡与所采用的插管策略直接相关。
双腔、双腔静脉插管可安全用于小儿患者，并发症发生率极低，是我们进行静脉 - 静脉体外膜肺氧合支持的首选方法。
