The evaluation of extracorporeal membrane oxygenation in clinical management of critically ill neonates
10.3760/cma.j.issn.2096-2932.2019.06.010
- VernacularTitle:体外膜肺氧合救治危重症新生儿的临床应用
- Author:
Chongbing YAN
1
;
Gang QIU
;
Yucai ZHANG
;
Jiangbin LIU
;
Yun CUI
;
Xiaohui GONG
;
Cheng CAI
;
Yunlin SHEN
;
Wenchao HONG
Author Information
1. 上海市儿童医院
- Keywords:
Intensive care units,neonatal;
Respiratory insufficiency;
Extracorporeal membrane oxygenation;
Clinical efficacy
- From:Chinese Journal of Neonatology
2019;34(6):448-452
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the clinical efficacy and safety of extracorporeal membrane oxygenation (ECMO) in critically ill neonates.Method From November 2016 to September 2018,the clinical data of 5 cases who received ECMO treatment in NICU of our hospital were retrospectively analyzed.The indication of ECMO was reversible respiratory failure irresponsive to conventional therapy.The treatment mode was V-A ECMO.Oxygenation index (OI),vasoactive-inotropic score,blood lactate before and 24 h after ECMO were recorded.Complications of ECMO were also studied.Paired t-test was used to compare the pre and post treatment parameters.Result Among the 5 cases,4 cases were male and 1 case was female.3 cases were diagnosed with meconium aspiration syndrome,2 cases pulmonary hypertension.OI[(9.5 ± 1.8) vs.(60.6 ± 19.4)],vasoactive-inotropic score[(19.5 ± 12.0) points vs.(204.0 ± 143.8) points]and blood lactate [(2.8 ± 1.5) mmol/L vs.(9.6 ± 3.6) mmol/L]) were all significantly decreased at 24 h after ECMO treatment (P ＜ 0.05).During follow-up,3 cases survived,2 cases died.All the 5 cases showed thrombocytopenia,3 cases developed renal failure and received continuous renal replacement therapy,1 case got intracranial hemorrhage.2 of the 3 survived cases developed neurological impairment and need long term follow-up and rehabilitation therapy.Conclusion ECMO treatment has remarkable effects on critically ill neonates and may actually save lives,but the risk of complications are quite high.
