Unidade de Cuidados Intensivos Pediátricos. Departamento de Pediatria. Hospital de Santa Maria. Centro Hospitalar Universitário de Lisboa Norte. Lisboa; Serviço de Pediatria. Centro Materno-Infantil do Norte. Centro Hospitalar Universitário do Porto. Porto. Portugal.
Unidade de Cuidados Intensivos Pediátricos. Departamento de Pediatria. Hospital de Santa Maria. Centro Hospitalar Universitário de Lisboa Norte. Lisboa. Portugal.
Acta Med Port. 2021 Jun 1;34(6):435-441. doi: 10.20344/amp.15227.
In Portugal, extracorporeal membrane oxygenation (ECMO) is used in pediatric patients since 2010. The aim of this study was to describe the clinical characteristics of patients, indications, complications and mortality associated with the use of ECMO during the first 10-years of experience in the Pediatric Intensive Care Unit located in Centro Hospitalar Universitário Lisboa Norte.
Retrospective observational cohort study of all patients supported with ECMO in a Pediatric Intensive Care Unit, from the 1st of May 2010 up to 31st December 2019.
Sixty-five patients were included: 37 neonatal (≤ 28 days of age) and 28 pediatric patients (> 28 days). In neonatal cases, congenital diaphragmatic hernia was the main reason for ECMO (40% of neonatal patients and 23% of total). Among pediatric patients, respiratory distress was the leading indication for ECMO (47% of total). The median length of ECMO support was 12 days. Clinical complications were more frequent than mechanical complications (65% vs 35%). Among clinical complications, access site bleeding was the most prevalent with 38% of cases. The overall patient survival was 68% at the time of discharge (65% for neonatal and 71% for pediatric cases), while the overall survival rate in Extracorporeal Life Support Organization registry was 61%. The number of ECMO runs has been increasing since 2011, even though in a non-linear way (three cases in 2010 to 11 cases in 2019).
In the first 10 years we received patients from all over the country. Despite continuous technological developments, circuitrelated complications have a significant impact. The overall survival rate in the Pediatric Intensive Care Unit was not inferior to the one reported by the Extracorporeal Life Support Organization.
The overall survival of our Pediatric Intensive Care Unit is not inferior to one reported by other international centers. Our experience showed the efficacy of the ECMO technique in a Portuguese centre.
自 2010 年以来，葡萄牙一直在儿科患者中使用体外膜肺氧合（ECMO）。本研究的目的是描述在位于里斯本北部中心医院的儿科重症监护病房的前 10 年经验中，与 ECMO 使用相关的患者临床特征、适应证、并发症和死亡率。
对 2010 年 5 月 1 日至 2019 年 12 月 31 日期间在儿科重症监护病房接受 ECMO 支持的所有患者进行回顾性观察队列研究。
共纳入 65 例患者：37 例新生儿（≤28 天）和 28 例儿科患者（＞28 天）。在新生儿中，先天性膈疝是 ECMO 的主要原因（占新生儿患者的 40%和总患者的 23%）。在儿科患者中，呼吸窘迫是 ECMO 的主要适应证（占总患者的 47%）。ECMO 支持的中位时间为 12 天。临床并发症比机械并发症更常见（65%比 35%）。在临床并发症中，最常见的是血管通路出血，占 38%。出院时患者总生存率为 68%（新生儿为 65%，儿科为 71%），而体外生命支持组织登记处的总生存率为 61%。自 2011 年以来，ECMO 运行次数一直在增加，尽管增长方式是非线性的（2010 年有 3 例，2019 年有 11 例）。
在最初的 10 年中，我们接收了来自全国各地的患者。尽管技术不断发展，但与回路相关的并发症仍有很大影响。儿科重症监护病房的总生存率与体外生命支持组织报告的生存率相当。
我们儿科重症监护病房的总体生存率与其他国际中心报告的生存率相当。我们的经验表明，ECMO 技术在葡萄牙中心是有效的。
