Department of Respiratory, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, No.9, Jinsui Road, Zhujiang New City, Tianhe District, Guangzhou, 510120, Guangdong, China.
Pediatric Intensive Care Unit, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.
BMC Pulm Med. 2023 Jan 30;23(1):41. doi: 10.1186/s12890-022-02284-5.
Severe adenovirus (Adv.) pneumonia can cause significant mortality in young children. There has been no worldwide consensus on the impact of extracorporeal membrane oxygenation (ECMO) in immunocompetent children with severe Adv. pneumonia. This study aimed to assess the impact of ECMO in immunocompetent children with severe Adv. pneumonia.
This study evaluated the medical records of 168 hospitalized children with severe Adv. pneumonia at the Guangzhou Women and Children's Medical Center between 2019 and 2020.Nineteen patients in the ECMO group and 149 patients in the non-ECMO group were enrolled.
Between these two groups, there were no differences in host factors such as sex, age (all P > 0.05). Significant differences were observed in shortness of breath/increased work of breathing; cyanosis; seizures; tachycardia; the partial pressure of oxygen in arterial blood (PO); the ratio of PaO to the fraction concentration of oxygen in inspired air (FiO; P/F); white blood cell, lymphocyte, monocytes, lactate dehydrogenase (LDH), serum albumin, and procalcitonin levels; and, pulmonary consolidation (all P < 0.05). There were significant differences in the parameters of mechanical ventilation (MV) therapy and complications such as respiratory failure, acute respiratory distress syndrome, septic shock, length of hospitalization, and death (all P < 0.05). The maximum axillary temperatures, respiratory rates, heart rates and LDH levels after receiving ECMO were significantly lower than those before ECMO (all P < 0.05). Additionally, SPO, PO, and P/F were significantly higher than those before ECMO (all P < 0.05). In MV therapy, FiO, PIP, and PEEP were significantly lower than those before ECMO (all P < 0.05).
In our study, the clinical conditions of the patients in the ECMO group were much more severe than those in the non-ECMO group. Our study showed that ECMO might be beneficial for the patients with severe Adv. pneumonia.
严重腺病毒（Adv.）肺炎可导致幼儿死亡率显著增加。对于免疫功能正常的重症 Adv. 肺炎患儿，体外膜肺氧合（ECMO）的影响尚未达成全球共识。本研究旨在评估 ECMO 对免疫功能正常的重症 Adv. 肺炎患儿的影响。
本研究评估了 2019 年至 2020 年期间在广州市妇女儿童医疗中心住院的 168 例重症 Adv. 肺炎患儿的病历。将 19 例 ECMO 组患儿和 149 例非 ECMO 组患儿纳入研究。
两组患儿在性别、年龄等宿主因素方面无差异（均 P>0.05）。两组患儿在呼吸困难/呼吸做功增加、发绀、惊厥、心动过速、动脉血氧分压（PO）、动脉血氧分压与吸入氧分数浓度比（PaO/FiO；P/F）、白细胞、淋巴细胞、单核细胞、乳酸脱氢酶（LDH）、血清白蛋白、降钙素原水平、肺部实变等方面存在显著差异（均 P<0.05）。在机械通气（MV）治疗和呼吸衰竭、急性呼吸窘迫综合征、感染性休克、住院时间、死亡等并发症方面存在显著差异（均 P<0.05）。ECMO 后患儿的最高腋温、呼吸频率、心率和 LDH 水平均明显低于 ECMO 前（均 P<0.05）。同时，PO、P/F 明显高于 ECMO 前（均 P<0.05）。在 MV 治疗中，FiO、PIP 和 PEEP 明显低于 ECMO 前（均 P<0.05）。
在本研究中，ECMO 组患儿的临床状况明显比非 ECMO 组患儿严重。本研究表明，ECMO 可能对重症 Adv. 肺炎患儿有益。
