在儿童中过量服用通道阻断剂后,中央外体膜氧化支持
Robert A Sorabella1, William H Gray1, Robert J Dabal1
1From the Division of Cardiothoracic Surgery, Section of Pediatric Cardiac Surgery, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama.
ASAIO journal (American Society for Artificial Internal Organs : 1992)
|November 17, 2023
概括
在儿童中过量服用通道阻断剂引起的阻断性血管扩张性休克很难治疗. 中央体外膜氧化 (ECMO) 为需要机械循环支持的儿科患者提供安全有效的解决方案.
科学领域:
- 儿科重症监护医学 儿科重症监护医学
- 心血管外科心血管外科
- 临床毒理学 临床毒理学
背景情况:
- 在大量通道阻塞剂 (CCB) 过量服用后,耐火性血管扩张性休克 (RVS) presents显著的临床挑战.
- 外周静脉外体膜氧化 (ECMO) 用于CCB中毒,但由于血管大小,对儿科患者构成挑战.
- 儿科患者往往需要高流量机械循环支持,复杂的外围ECMO管道.
研究的目的:
- 评估主要中央体外膜氧化 (ECMO) 管策略的安全性和有效性.
- 评估儿童和青少年患有深度RVS由于CCB过量使用中央ECMO治疗的RVS患者的结果.
- 为了确定中央ECMO是否是一种可行的早期干预,用于儿童群体中严重的CCB诱导的血管扩张性休克.
主要方法:
- 在CCB过量服用后入院的四名儿科和青少年患者的回顾性病例系列.
- 实施"初级"中央ECMO通道方法,用于机械循环支持.
- 监测患者的结果,包括医院出院和长期发病率.
主要成果:
- 所有四名接受初级中央ECMO治疗的患者都幸存下来,并成功从医院出院.
- 在最近的随访中,患者没有观察到晚期发病率.
- 中央ECMO在这个儿科队列中为严重的RVS提供了有效的机械循环支持.
结论:
- 主要的中央ECMO注射管是一种安全有效的策略,用于管理儿童和青少年在CCB过量后患有深度RVS的患者.
- 对于患有严重疾病的儿科患者,应及早考虑中央ECMO,因为CCB摄入而经历大规模血管扩展性休克.
- 这种方法克服了与较小小儿血管系统的外围ECMO相关的挑战.
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