Morava E, Gill W, Pierce M
Department of Pediatrics, Tulane Medical Center New Orleans, USA.
Orv Hetil. 1998 Feb 22;139(8):403-6.
Extracorporeal life support and extracorporeal membrane oxygenation characterize the use of mechanical devices for temporary support of heart and lung function. The mechanical circuit consists of a blood pump (heart), membrane oxygenator (lung: which accomplishes both carbon dioxide removal and oxygen delivery), heat exchanger and a servo-control module. Venous blood is drained from the right atrium through the right internal jugular vein, and returned oxygenated through either the right common carotid artery (venoarterial bypass), or into a large vein (venovenous bypass). All patients treated must be free of coagulopathies, as all patients are anticoagulated. Neonatal candidates should be older than 34 weeks gestational age and weigh more than 2000 grams. As of March, 1997 twenty six patients have been treated with extracorporeal life support at Tulane Medical Center with an overall survival rate of 62%. Twelve neonates with either meconium aspiration or pneumonia have been treated with a 100% survival. Six children with congenital diaphragmatic hernia have been unsuccessfully treated.
体外生命支持和体外膜肺氧合是利用机械设备临时支持心肺功能的特点。机械回路由血泵（心脏）、膜式氧合器（肺：既能去除二氧化碳又能输送氧气）、热交换器和一个伺服控制模块组成。静脉血通过右颈内静脉从右心房引出，并通过右颈总动脉（静脉 - 动脉旁路）或大静脉（静脉 - 静脉旁路）进行氧合后返回。所有接受治疗的患者必须没有凝血障碍，因为所有患者都要进行抗凝治疗。新生儿候选者的胎龄应大于34周，体重应超过2000克。截至1997年3月，图兰大学医学中心已有26例患者接受了体外生命支持治疗，总生存率为62%。12例患有胎粪吸入或肺炎的新生儿接受了治疗，生存率为100%。6例患有先天性膈疝的儿童治疗失败。
