O'Connor T A, Haney B M, Grist G E, Egelhoff J C, Snyder C L, Ashcraft K W
Sections of Neonatology, Children's Mercy Hospital, Kansas City, MO.
J Pediatr Surg. 1993 Oct;28(10):1332-5. doi: 10.1016/s0022-3468(05)80323-9.
Intracranial hemorrhage (ICH) remains one of the more common serious complications of extracorporeal membrane oxygenation (ECMO) in neonates. In 1990 this center began routine use of cephalic jugular venous drainage during neonatal ECMO to augment blood return to the ECMO pump and potentially decrease the incidence of ICH by decreasing cerebral venous pressure. Thirty-four ECMO cases utilizing cephalic jugular venous drainage were compared with the previous 34 ECMO cases. The incidence of ICH decreased from 35% (12/34) to 6% (2/34) when neonates without cephalic jugular venous drainage are compared with those being subject to this technique (P < .01). No differences were found between the two groups in gestational age, birth weight, duration of ECMO, survival, platelet counts, activated clotting times, or incidence of other bleeding complications. Cephalic jugular venous drainage during neonatal ECMO appears to be safe and may decrease the incidence of ICH.
颅内出血（ICH）仍然是新生儿体外膜肺氧合（ECMO）较为常见的严重并发症之一。1990年，该中心开始在新生儿ECMO期间常规使用头臂静脉引流，以增加血液回流到ECMO泵，并可能通过降低脑静脉压来降低ICH的发生率。将34例采用头臂静脉引流的ECMO病例与之前的34例ECMO病例进行比较。当将未采用头臂静脉引流的新生儿与采用该技术的新生儿进行比较时，ICH的发生率从35%（12/34）降至6%（2/34）（P <.01）。两组在胎龄、出生体重、ECMO持续时间、生存率、血小板计数、活化凝血时间或其他出血并发症的发生率方面均未发现差异。新生儿ECMO期间的头臂静脉引流似乎是安全的，并且可能降低ICH的发生率。
