Haung Y Z, Tso A S, Lee S R, Sun M S, Lin S M, Tsai S K
Department of Anesthesiology, Far Eastern Memorial Hospital, Taiwan, R.O.C.
Acta Anaesthesiol Sin. 1998 Mar;36(1):43-7.
Right ventricular dysfunction after surgical repair of tetralogy is a serious life threatening complication. Although pulmonary vasodilators and inotropes can be used for cardiac support in tetralogy repair, these drugs may be ineffective in some patients. To date extracorporeal membrane oxygenation (ECMO) support may be used effectively in these patients when medical therapy fails. We report a case with successful ECMO support in right ventricular dysfunction and pulmonary hypertension after total surgical correction of Fallot's tetralogy. ECMO circuit was instituted in the operating room due to difficulty in weaning from cardiopulmonary bypass in spite of aggressive medical therapy. We reviewed and discussed the indications, contraindications of application of ECMO and patient survival with treatment of ECMO. At the same time we wish to share our limited experience we gained in our first attempt of ECMO support.
法洛四联症手术修复后出现的右心室功能障碍是一种严重的、危及生命的并发症。尽管肺血管扩张剂和正性肌力药物可用于法洛四联症修复术中的心脏支持，但这些药物在某些患者中可能无效。迄今为止，当药物治疗失败时，体外膜肺氧合（ECMO）支持可有效地用于这些患者。我们报告了一例在法洛四联症完全手术矫正后，成功应用ECMO支持治疗右心室功能障碍和肺动脉高压的病例。尽管进行了积极的药物治疗，但由于在脱离体外循环时遇到困难，ECMO回路在手术室中建立。我们回顾并讨论了ECMO应用的适应证、禁忌证以及接受ECMO治疗的患者生存率。同时，我们希望分享我们在首次尝试ECMO支持时获得的有限经验。
