心臓外科手術後の心停止中の小児における体外膜酸素器の救助
P J del Nido1, H J Dalton, A E Thompson
1Department of Surgery, University of Pittsburgh School of Medicine, PA.
Circulation
|November 1, 1992
まとめ
身体外膜酸素化 (ECMO) は,開心手術後に心停止を経験する子供にとって,長期にわたる心肺蘇生 (CPR) の後でも,実行可能な救助療法を提供します. この機械的なサポートは,選択された小児患者の生存率を有望に示しています.
科学分野:
- ペディアトリック・カルディオロジー
- 心血管外科手術についてです.
- クリティカルケア・メディシン
背景:
- 従来の心肺蘇生 (CPR) は,オープンハート手術後の小児性心停止ではしばしば失敗します.
- 胸を開けたマッサージは,これらの重大なケースでは不十分かもしれません.
研究 の 目的:
- 心臓外科手術後の循環停止の子どもに対する救助療法としての機械的サポートの有効性を検討する.
- この患者集団における体外膜酸化 (ECMO) のアウトカムを評価する.
主な方法:
- 1981年から1991年の間に33人の子供に心臓のメカニカルサポートのための体外膜酸素器 (ECMO) 回路を使用しました.
- オープンハート手術後に従来の心肺蘇生に耐え難い心停止を経験した11人の患者に焦点を当てました.
主要な成果:
- ECMOは,CPRの平均持続時間65分後に開始され,112時間続いた.
- 早期生存率は64% (11人のうち7人) であり,そのうち1人が心臓移植を必要とした.
- 死因には,神経学的合併症と心臓機能不全が挙げられ,生存者の1人にセプシスが発生した.
結論:
- ECMOは,心筋切開術後の心停止の選択された小児患者のための実行可能な救済オプションです.
- 長時間 (最大60分) の心肺蘇生 (CPR) を施しても,成功することが可能である.
- 生存した患者では,長期的な続変は観察されなかった.
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