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Implantation of Total Artificial Heart in Congenital Heart Disease
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髄膜球菌病による難治性心呼吸器不全に対する体外のサポート
A P Goldman1, S J Kerr, W Butt
1Great Ormond Street Hospital for Children, London, UK.
Lancet (London, England)
|February 15, 1997
まとめ
身体外膜酸素化 (ECMO) は,重度の髄膜球菌病と心肺機能不全の患者をサポートすることができます. この心臓肺機械療法は,標準治療に反応しない重症患者の生存のチャンスを提供します.
科学分野:
- 小児重症病棟医療 幼児重症病棟医療
- 心肺支援技術について
- 感染症 感染症は感染症です.
背景:
- 髄膜炎球菌疾患は,主に耐性心筋圧縮,低血圧,重度の急性呼吸器障害症候群による重大な死亡率を引き起こします.
- 身体外膜酸素化 (ECMO) は,心臓肺装置を使用して一時的な心臓および呼吸器のサポートを提供します.
- 本研究では, meningokoccal diseaseに対するECMOに関する英国とオーストラリアの経験をレビューしています.
研究 の 目的:
- 髄膜炎球菌疾患および耐性心肺衰竭の小児患者におけるECMOの有効性およびアウトカムを評価する.
- 重度の髄膜球菌感染症における救助療法としてのECMOの役割を評価する.
主な方法:
- イギリスとオーストラリアで1989年から2007年の間に髄膜炎球菌疾患のためにECMOを受けた12人の小児患者の遡及的レビュー.
- 患者の人口統計,ECMO (心不全と呼吸器不全) の用例,ECMO以前の介入,およびアウトカムに関する分析.
主要な成果:
- 12人の患者 (平均年齢26ヶ月) は,髄膜炎球菌疾患のためにECMOを受けた.
- 治療不可能なショックのために7人の患者が早期ECMOを必要とし,呼吸不全のために5人が後でECMOを必要とした.
- 12人の患者のうち8人は生存し,6人は追跡時に正常な生活を達成しました.
結論:
- ECMOは,治療不可能な心肺機能不全を経験している Meningococal疾患の小児患者にとって有効な選択肢です.
- ECMOの検討は,重症で治療に耐性のある髄膜球菌症例の生存率を改善する可能性があります.
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