Division of Pediatric Critical Care Medicine, Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, New York.
Department of Pediatric Cardiothoracic Surgery, Shand's Children's Hospital, University of Florida, Gainsville, Florida.
Pediatr Pulmonol. 2020 Jun;55(6):1311-1319. doi: 10.1002/ppul.24751. Epub 2020 Mar 30.
Asthma is the most common chronic illness and is one of the most common medical emergencies in children. Progressive refractory near-fatal asthma requiring intubation and mechanical ventilation can lead to death. Extracorporeal membrane oxygenation (ECMO) can provide adequate gas exchange during acute respiratory failure although data on outcomes in children requiring ECMO support for status asthmaticus is sparse with one study reporting survival rates of nearly 85% with asthma being one of the best outcome subsets for patients with refractory respiratory failure requiring ECMO support. We describe the current literature on the use of ECMO and other advanced extracorporeal therapies available for children with acute severe asthma. We also review other advanced invasive and noninvasive therapies in acute severe asthma both before and while on ECMO support.
哮喘是最常见的慢性疾病之一，也是儿童中最常见的急症之一。进展性难治性濒死性哮喘需要插管和机械通气，可导致死亡。体外膜氧合 (ECMO) 可在急性呼吸衰竭时提供充足的气体交换，尽管关于 ECMO 支持哮喘急性发作患儿结局的数据很少，但有一项研究报告哮喘患者的生存率接近 85%，对于需要 ECMO 支持的难治性呼吸衰竭患者，哮喘是最佳结局亚组之一。我们描述了目前关于 ECMO 及其他可用于急性重度哮喘儿童的体外生命支持技术的应用文献。我们还回顾了 ECMO 支持前后急性重度哮喘的其他先进的有创和无创治疗方法。
