Khan J Y, Kerr S J, Tometzki A, Tyszczuk L, West J, Sosnowski A, McCrae D, Skeoch C, Davis C, Firmin R K
Glenfield Hospital, Leicester.
Arch Dis Child Fetal Neonatal Ed. 1995 Sep;73(2):F91-4. doi: 10.1136/fn.73.2.f91.
To report the collaborative experience of extracorporeal membrane oxygenation (ECMO) in the treatment of respiratory syncytial virus (RSV) bronchiolitis between April 1989 and January 1995.
The medical records of patients with confirmed RSV bronchiolitis referred to three centres (Leicester, Glasgow, and Great Ormond Street) were reviewed.
Twenty four infants were identified. Seventeen had been born prematurely (gestational range 23-40 weeks, median 30 weeks). Thirteen infants had been mechanically ventilated after birth and seven of these had evidence of bronchopulmonary dysplasia (BPD). The age of onset of RSV infection varied from three to 64 weeks (mean 17.4 weeks, median 12 weeks). Ventilation before ECMO ranged from one to 16 days and oxygenation indices at the time of referral ranged from 21-73 (mean 39). Ribavirin was used in eight of the 24 patients. Sixteen patients received venoarterial and eight veno-venous ECMO. ECMO hours ranged from 32-647 (median 196 hours). One infant died (survival rate 96%). Cranial ultrasound abnormalities were detected in three patients. However, at follow up only one of the 23 survivors had evidence of developmental delay.
A group of paediatric patients in whom ECMO can be of benefit has been identified. The use of ECMO should be considered when other means of support prove unsuccessful.
报告1989年4月至1995年1月期间体外膜肺氧合（ECMO）治疗呼吸道合胞病毒（RSV）细支气管炎的协作经验。
回顾了转诊至三个中心（莱斯特、格拉斯哥和大奥蒙德街）的确诊RSV细支气管炎患者的病历。
共确定了24名婴儿。其中17名早产（孕周范围23 - 40周，中位数30周）。13名婴儿出生后接受了机械通气，其中7名有支气管肺发育不良（BPD）的证据。RSV感染的发病年龄从3周到64周不等（平均17.4周，中位数12周）。ECMO前的通气时间为1至16天，转诊时的氧合指数为21 - 73（平均39）。24名患者中有8名使用了利巴韦林。16名患者接受了静脉 - 动脉ECMO，8名接受了静脉 - 静脉ECMO。ECMO支持时间为32 - 647小时（中位数196小时）。1名婴儿死亡（存活率96%）。3名患者检测到颅脑超声异常。然而，在随访中，23名存活者中只有1名有发育迟缓的证据。
已确定一组可从ECMO中获益的儿科患者。当其他支持手段证明无效时，应考虑使用ECMO。
