Yamagishi T, Ishikawa S, Otaki A, Otani Y, Takahashi T, Sato Y, Yoshida I, Kunimoto F, Arai K, Morishita Y
Second Department of Surgery, Gunma University School of Medicine, Japan.
Surg Today. 1995;25(8):690-3. doi: 10.1007/BF00311484.
We report herein our experience with extracorporeal membrane oxygenation (ECMO) for respiratory failure over a 3-year period. ECMO was employed in seven patients: in five for respiratory failure caused by adult respiratory distress syndrome (ARDS), Goodpasture's syndrome, hypoxia after ventricular septal defect closure, interstitial pneumonia, or lung metastasis from choriocarcinoma; and in two for tracheal obstruction. Nafamostat mesilate was used as the main anticoagulant with a small amount of heparin. The period of ECMO support for the five patients with respiratory failure ranged from 54 to 251 h, with an average time of 125 h. Five of the seven patients were able to be weaned from ECMO, and the two who had tracheal obstruction survived. The other three patients who were weaned from ECMO died of underlying diseases or complications 1-25 days after weaning. The complications which occurred during ECMO support were an abnormal electroencephalogram, multiple organ failure, and mediastinitis. Thus, we conclude that ECMO needs to be induced early to obtain a better outcome in patients with respiratory failure, and that it is particularly effective for transient airway obstruction.
我们在此报告我们在3年期间使用体外膜肺氧合（ECMO）治疗呼吸衰竭的经验。7例患者接受了ECMO治疗：5例因成人呼吸窘迫综合征（ARDS）、Goodpasture综合征、室间隔缺损修补术后缺氧、间质性肺炎或绒毛膜癌肺转移导致呼吸衰竭；2例因气管阻塞。甲磺酸萘莫司他用作主要抗凝剂，并辅以少量肝素。5例呼吸衰竭患者的ECMO支持时间为54至251小时，平均时间为125小时。7例患者中有5例成功撤机，2例气管阻塞患者存活。另外3例撤机患者在撤机后1至25天死于基础疾病或并发症。ECMO支持期间发生的并发症包括脑电图异常、多器官功能衰竭和纵隔炎。因此，我们得出结论，对于呼吸衰竭患者，需要早期应用ECMO以获得更好的疗效，并且它对短暂性气道阻塞特别有效。
