Chyka P A
University of Tennessee, Southern Poison Center, Memphis 38163, USA.
J Toxicol Clin Toxicol. 1996;34(4):357-63. doi: 10.3109/15563659609013804.
To review the therapeutic benefits of extracorporeal membrane oxygenation for the management of hydrocarbon pneumonitis.
A search of the medical literature was conducted through Medline and the bibliographies of relevant articles and a search of patient databases maintained by the Extracorporeal Life Support Organization and the American Association of Poison Control Centers was performed. All articles and case reports on the use of extracorporeal membrane oxygenation in patients with hydrocarbon pneumonitis were selected. The data were abstracted without judgments about study design.
There is some evidence that pulmonary parenchymal tissue can recover from hydrocarbon pneumonitis, but the degree of injury and recovery are variable. In the Extracorporeal Life Support Organization Registry 19 children with hydrocarbon pneumonitis were treated with extracorporeal membrane oxygenation during 1985 to 1994 and 68% survived compared to the 52% overall survival of 883 pediatric cases who had a diagnosis of a respiratory condition. A review of the American Association of Poison Control Centers data for 1993 and 1994 identified five cases of hydrocarbon pneumonitis in which extracorporeal membrane oxygenation was used and two survived. There are two full case descriptions in the literature with both children surviving, but one child developed persistent moderate left hemiparesis and seizure activity.
The need for extracorporeal membrane oxygenation is rare owing to the generally good outcome of most cases of hydrocarbon ingestions and pneumonitis. Only with further research on the nature and clinical course of severe hydrocarbon pneumonitis, refinement of extracorporeal membrane oxygenation criteria, and evaluation of alternative therapies, will the benefits of extracorporeal membrane oxygenation be better defined.
回顾体外膜肺氧合在碳氢化合物肺炎治疗中的益处。
通过医学文献数据库（Medline）及相关文章的参考文献进行医学文献检索，并检索体外生命支持组织和美国中毒控制中心协会维护的患者数据库。选取所有关于体外膜肺氧合用于碳氢化合物肺炎患者的文章和病例报告。提取数据时不对研究设计进行评判。
有证据表明肺实质组织可从碳氢化合物肺炎中恢复，但损伤程度和恢复情况各不相同。在体外生命支持组织登记处，1985年至1994年期间有19例碳氢化合物肺炎患儿接受了体外膜肺氧合治疗，其中68%存活，而883例诊断为呼吸系统疾病的儿科病例总体存活率为52%。回顾美国中毒控制中心协会1993年和1994年的数据，确定有5例碳氢化合物肺炎使用了体外膜肺氧合，2例存活。文献中有两例完整病例描述，两名患儿均存活，但其中一名患儿出现持续性中度左半身轻瘫和癫痫发作。
由于大多数碳氢化合物摄入和肺炎病例的总体预后良好，体外膜肺氧合的需求很少。只有进一步研究严重碳氢化合物肺炎的性质和临床病程，完善体外膜肺氧合标准，并评估替代疗法，才能更好地明确体外膜肺氧合的益处。
