Riccabona M, Kuttnig-Haim M, Dacar D, Urlesberger B, Reiterer F, Maurer U, Zobel G
Department of Pediatric Radiology, University Hospital, LKH Graz, Auenbruggerplatz, A-8036 Graz, Austria.
Eur Radiol. 1997;7(9):1383-6. doi: 10.1007/s003300050305.
The purpose of our study was to evaluate thrombosis of venous vessels during and after extracorporeal membrane oxygenation (ECMO) using color Doppler sonography. We prospectively performed serial color Doppler sonography investigations in 30 ECMO patients [age: newborn to 3 years, male:female = 20:10, venoarterial (VA) ECMO = 18, venovenous (VV) ECMO = 12]. During ECMO obstruction and/or thrombosis of the superior vena cava (SVC) was observed in 2 neonates on VA ECMO. Furthermore, a thrombotic clot from an initially open duct of Arantii with partial portal vein thrombosis, reaching into the inferior vena cava (IVC), occurred despite adequate heparinization. After ECMO, late septic SVC thrombus occurred in one neonate. IVC thrombus was observed in two pediatric VV ECMO patients. The overall incidence of venous clots was 20 % (6 of 30). Routine color Doppler sonography monitoring of vessels in children on and after ECMO was found to be useful for early detection of venous thrombosis. It enabled consequent administration of appropriate therapy as well as follow-up after decannulation and reconstruction.
我们研究的目的是使用彩色多普勒超声评估体外膜肺氧合（ECMO）期间及之后静脉血管的血栓形成情况。我们前瞻性地对30例ECMO患者进行了系列彩色多普勒超声检查[年龄：新生儿至3岁，男∶女 = 20∶10，静脉 - 动脉（VA）ECMO = 18例，静脉 - 静脉（VV）ECMO = 12例]。在ECMO期间，2例接受VA ECMO的新生儿观察到上腔静脉（SVC）梗阻和/或血栓形成。此外，尽管肝素化充分，但仍出现了一例来自最初开放的动脉导管且伴有部分门静脉血栓形成并延伸至下腔静脉（IVC）的血栓。在ECMO之后，1例新生儿出现了迟发性感染性SVC血栓。在2例接受儿科VV ECMO的患者中观察到IVC血栓。静脉血栓的总体发生率为20%（30例中的6例）。结果发现，对接受ECMO的儿童在ECMO期间及之后进行血管的常规彩色多普勒超声监测有助于早期发现静脉血栓形成。这能够随后给予适当的治疗以及在拔管和重建后进行随访。
