Kiyama H, Ohshima N, Hata I, Imazeki T, Yamada T
Department of Cardiovascular Surgery, Sekishinkai Sayama Hospital, Saitama, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1996 Oct;44(10):1912-6.
A 23-year-old man, diagnosed as ventricular septal defect in childhood, was hospitalized with right-sided infective endocarditis. He developed acute respiratory failure following septic pulmonary emboli and underwent urgent surgical treatment, because vigorous medical treatment was ineffective. Extracorporeal membrane oxygenation was performed to maintain arterial blood oxygen tension after cardiopulmonary bypass and the patient was weaned from ECMO after 36 hours. Postoperatively, mechanical ventilation for respiratory failure was needed continuously and pleural leaks due to lung injuries were increased. The reduction of pleural leaks by surgical closure of fistula and plication of the cyst decreased gas exchange impairment. To our knowledge, application of extracorporeal membrane oxygenation for septic pulmonary emboli is unprecedented.
一名23岁男性，童年时被诊断为室间隔缺损，因右侧感染性心内膜炎入院。他在发生感染性肺栓塞后出现急性呼吸衰竭，由于积极的药物治疗无效，接受了紧急手术治疗。体外膜肺氧合在体外循环后用于维持动脉血氧张力，患者在36小时后脱离体外膜肺氧合。术后，因呼吸衰竭需要持续进行机械通气，且因肺损伤导致的胸膜渗漏增多。通过手术闭合瘘口和折叠囊肿来减少胸膜渗漏，减轻了气体交换障碍。据我们所知，将体外膜肺氧合应用于感染性肺栓塞是前所未有的。
