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新生儿肺衰竭体外膜肺氧合治疗后幸存者的早期评估

The early evaluation of survivors after extracorporeal membrane oxygenation for neonatal pulmonary failure.

作者信息

Krummel T M, Greenfield L J, Kirkpatrick B V, Mueller D G, Kerkering K W, Ormazabal M, Myer E C, Barnes R W, Salzberg A M

出版信息

J Pediatr Surg. 1984 Oct;19(5):585-90. doi: 10.1016/s0022-3468(84)80110-4.

Abstract

Excluding mortality data, there is little information regarding patients' development after extra corporeal membrane oxygenation (ECMO). In six of nine neonates surviving ECMO for predictably fatal pulmonary failure, examination 15 to 21 months afterward showed (1) physical growth and development, normal in six; (2) chest x-ray, normal pulmonary parenchyma; (3) average arterial blood gases, PO2 80, Pco2 35, pH 7.35; (4) echocardiogram, normal, without evidence of pulmonary hypertension; (5) cerebrovascular dopplers, normal ophthalmic artery flow in five patients, retrograde in one; (6) CT scan, EEG, neurologic survey, normal in five, cerebral atrophy in one patient who had an air embolus during decannulation; (7) psychologic examination, normal in all. This early evaluation of ECMO survivors should encourage its further application in those newborns who would otherwise die.

摘要

排除死亡率数据后,关于接受体外膜肺氧合(ECMO)治疗后患者的发育情况,几乎没有相关信息。在因可预测的致命性肺衰竭而接受ECMO治疗存活下来的9例新生儿中,有6例在15至21个月后的检查显示:(1)身体生长发育,6例正常;(2)胸部X光片,肺实质正常;(3)平均动脉血气,PO2 80,Pco2 35,pH 7.35;(4)超声心动图,正常,无肺动脉高压迹象;(5)脑血管多普勒检查,5例患者眼动脉血流正常,1例逆行;(6)CT扫描、脑电图、神经学检查,5例正常,1例在拔管期间发生空气栓塞的患者出现脑萎缩;(7)心理检查,全部正常。对ECMO幸存者的这种早期评估应鼓励在那些否则会死亡的新生儿中进一步应用该治疗方法。

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