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Apoyo extracorpóreo para la insuficiencia cardiorrespiratoria intractable debido a la enfermedad meningocócica
A P Goldman1, S J Kerr, W Butt
1Great Ormond Street Hospital for Children, London, UK.
Lancet (London, England)
|February 15, 1997
Resumen
La oxigenación de la membrana extracorpórea (ECMO) puede apoyar a los niños con enfermedad meningocócica grave e insuficiencia cardiorrespiratoria. Esta terapia de máquina corazón-pulmón ofrece una oportunidad de supervivencia para pacientes en estado crítico que no responden a los tratamientos estándar.
Área de la Ciencia:
- Medicina de Cuidados Críticos Pediátricos.
- Tecnologías de apoyo cardiopulmonar Tecnologías de apoyo cardiopulmonar
- Enfermedades infecciosas Enfermedades infecciosas.
Sus antecedentes:
- La enfermedad meningocócica causa una mortalidad significativa, principalmente debido a la depresión miocárdica refractaria, la hipotensión y el síndrome de dificultad respiratoria aguda grave.
- La oxigenación de la membrana extracorpórea (ECMO) proporciona apoyo cardíaco y respiratorio temporal utilizando una máquina corazón-pulmón.
- Este estudio revisa la experiencia del Reino Unido y Australia con ECMO para la enfermedad meningocócica.
Objetivo del estudio:
- Evaluar la eficacia y los resultados de la ECMO en pacientes pediátricos con enfermedad meningocócica e insuficiencia cardiorrespiratoria refractaria.
- Evaluar el papel de la ECMO como terapia de rescate en las infecciones meningococales graves.
Principales métodos:
- Una revisión retrospectiva de 12 pacientes pediátricos que recibieron ECMO para la enfermedad meningocócica entre 1989 y 2007 en el Reino Unido y Australia.
- Análisis de la demografía de los pacientes, las indicaciones para la ECMO (insuficiencia cardíaca frente a la insuficiencia respiratoria), las intervenciones previas a la ECMO y los resultados.
Principales resultados:
- Doce pacientes (edad media de 26 meses) recibieron ECMO para la enfermedad meningocócica.
- Siete pacientes requirieron ECMO temprana para el shock intratable; cinco lo requirieron más tarde para la insuficiencia respiratoria.
- Ocho de los 12 pacientes sobrevivieron, y seis lograron vidas normales en el seguimiento.
Conclusiones:
- La ECMO es una opción viable para pacientes pediátricos con enfermedad meningocócica que experimentan insuficiencia cardiorrespiratoria intractable.
- La consideración de la ECMO puede mejorar las tasas de supervivencia en casos graves de meningococos refractarios al tratamiento.
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