Trant C A, Casey J R, Hansell D, Cheifetz I, Meliones J N, Ungerleider R M, Browning I, Greeley W J
Department of Pediatrics, Duke University Medical Center, Durham, North Carolina, USA.
ASAIO J. 1996 May-Jun;42(3):236-9.
Extracorporeal membrane oxygenation (ECMO) is widely used in the treatment of respiratory and cardiovascular failure in neonatal patients. The authors present a case of a child with hemoglobin SS disease who was treated with ECMO after acute chest syndrome and acute respiratory distress syndrome developed. They also present data from the Extracorporeal Life Support Organization on this use of ECMO from other centers. To date, there have been 15 pediatric patients with acute chest syndrome treated with ECMO. Survival rate has been 26%. In selected patients with severe disease, ECMO can provide support at a lower mean airway pressure, allow for aggressive pulmonary lavage, and maintain adequate tissue oxygen delivery until the patient is more stable. Patients who might benefit include those with poor ventilation secondary to mucous plugging and barotrauma. The best success with these patients might be anticipated from venoarterial ECMO. Patients with severe cardiac or neurologic deterioration may constitute a group less likely to survive.
体外膜肺氧合（ECMO）广泛应用于新生儿呼吸和心血管衰竭的治疗。作者报告了1例患有血红蛋白SS病的儿童，在发生急性胸综合征和急性呼吸窘迫综合征后接受了ECMO治疗。他们还展示了体外生命支持组织提供的关于其他中心使用ECMO治疗该病的相关数据。截至目前，共有15例患有急性胸综合征的儿科患者接受了ECMO治疗，生存率为26%。对于部分病情严重的患者，ECMO可在较低的平均气道压下提供支持，便于进行积极的肺灌洗，并在患者病情更稳定之前维持充足的组织氧输送。可能受益的患者包括因黏液阻塞和气压伤导致通气不良的患者。对于这些患者，静脉-动脉ECMO可能会取得最佳疗效。严重心脏或神经功能恶化的患者可能属于生存率较低的群体。
