Dela Cruz T V, Stewart D L, Robinson T W, Bond S J
Department of Pediatrics, University of Louisville School of Medicine, KY 40292, USA.
ASAIO J. 1996 May-Jun;42(3):230-2.
Extracorporeal membrane oxygenation (ECMO) has been successful in rescuing near term or term infants in cardio-respiratory failure that results from a reversible disease process. In most cases, only one course of ECMO is needed to save these infants. However, a second course of ECMO may be beneficial in a select group of infants when recurrent persistent pulmonary hypertension develops. Other than abstract form, this is the first report of the use of a second course of ECMO in the literature. The authors report on three infants, two with recurrent persistent pulmonary hypertension secondary to congenital diaphragmatic hernia and one with necrotizing tracheobronchitis after Group B streptococcal sepsis who were treated at their institution with a second course of ECMO. Technical considerations in using a second course of ECMO depend upon the initial vessel cannulation site, time elapsed between cannulations, and the condition of the original artery and vein. By adopting a stenting procedure in those infants whose initial trial off was equivocal, a second cannulation may be prevented in neonatal patients with recurrent persistent pulmonary hypertension.
体外膜肺氧合（ECMO）已成功挽救了因可逆性疾病过程导致心肺功能衰竭的近足月或足月婴儿。在大多数情况下，挽救这些婴儿仅需一个疗程的ECMO。然而，当复发性持续性肺动脉高压发展时，第二个疗程的ECMO可能对一组特定的婴儿有益。除摘要形式外，本文是文献中关于使用第二个疗程ECMO的首例报告。作者报告了三名婴儿，两名因先天性膈疝继发复发性持续性肺动脉高压，一名在B族链球菌败血症后发生坏死性气管支气管炎，他们在作者所在机构接受了第二个疗程的ECMO治疗。使用第二个疗程ECMO的技术考虑因素取决于初始血管插管部位、插管之间的时间间隔以及原来动脉和静脉的状况。对于那些初始撤机试验结果不明确的婴儿，通过采用支架置入程序，可防止复发性持续性肺动脉高压新生儿患者进行第二次插管。
