Clinical analyses of twelve children with acute respiratory distress syndrome treated by extracorporeal membrane oxygenation
10.3760/cma.j.issn.1673-4912.2018.09.007
- VernacularTitle:12例体外膜肺氧合救治儿童急性呼吸窘迫综合征的临床分析
- Author:
Chengxiang KONG
1
,
2
;
Xiaoyang HONG
;
Yingyue LIU
;
Ping JIN
;
Xiaojuan ZHANG
;
Zhe ZHAO
;
Haitao GAO
;
Zhichun FENG
Author Information
1. 518106 暨南大学附属深圳市宝安区妇幼保健院PICU
2. 100700 北京,陆军总医院附属八一儿童医院PICU
- Keywords:
Extracorporeal membrane oxygenation;
Acute respiratory distress syndrome;
Pediatrics
- From:
Chinese Pediatric Emergency Medicine
2018;25(9):673-677
- CountryChina
- Language:Chinese
-
Abstract:
Objective To summarize the clinical experience of extrocorporeal membrane oxygena-tion(ECMO) in the treatment of pediatric acute respiratory distress syndrome (ARDS). Methods A retro-spective analysis of children with ARDS who were hospitalized for different causes and received the treatment of ECMO from October 2012 to November 2017 was performed. The clinical conditions and prognostic fac-tors in the course of their disease were compared. Results In 12 cases of ARDS,9 cases (75％ ) had severe pneumonia,2 cases (16. 67％ ) had lung tumor resection and 1 case ( 8. 33％ ) had bronchial foreign body. Seven cases (58. 3％ ) chose VA-ECMO,5 (41. 7％ ) cases chose VV-ECMO. The average duration of ECMO was (225. 03 ± 214. 75) h. With the positive treatment of ECMO,heart rate,mixed venous oxygen saturation and central venous pressure all improved significantly(P < 0. 05),and there was no obvious abnor-mal changes in MAP and lactic acid(P > 0. 05). Arterial oxygen partial pressure,arterial carbon dioxide par-tial pressure,oxygenation index and P/ F were significantly improved after the ECMO support(P < 0. 05). Ppeak,Paw and PEEP after evacuation of ECMO were significantly lower than those before treatment (P <0. 05). Ten cases (83. 33％ ) were successfully removed,8 cases (66. 67％ ) were saved, and 4 cases (33. 33％ ) died. During the ECMO treatment,9 cases (75％ ) had complications,including 8 cases of bleed-ing at the intubation site,3 cases of gastrointestinal hemorrhage,2 cases of hemolysis,1 case of infection,2 cases of acute kidney injury,2 cases of neurological symptoms,1 case of multiple organ dysfunction syn-drome. Conclusion Pediatric ARDS is critical and the mortality rate is high. ECMO should be used as soon as possible when the lung is potentially regained and other treatments are ineffective,so that the lung could be fully rescued to gain time and opportunity for clinical treatment.
