体外膜肺氧合对急性心内膜炎三尖瓣置换术后心肺功能的支持

目的观察体外膜肺氧合（ECMO）对烧伤后并发心内膜炎,行三尖瓣置换术后低心排的临床应用效果。方法采用股动、静脉插管对1例烧伤后并发心内膜炎,行三尖瓣置换术后严重低心排患者进行ECMO支持。辅助期间平均流量在45～60mL.kg-1.min-1,血流动力学稳定。结果 ECMO辅助41 h 38 min后成功撤除;术后52 h拔出气管插管自主呼吸,生命体征平稳;术后21 d死于多器官功能衰竭。结论对于烧伤后并发急性心内膜炎行瓣膜置换的患者,ECMO是术后心脏功能支持的一种有效的机械辅助方法,可减低患者在ICU中的风险。

Utilization of extracorporeal membrane oxygenation to assist cardiorespiratory function after performing tricuspid valve implantation in burned patients

Objective To evaluate the clinical effect of extracorporeal membrane oxygenation（ECMO） for low cardiac output syndrome（LCOS） in adult burned patients with active tricuspid valve endocarditis after performing tricuspid valve implantation.Methods ECMO was performed on one burned patient with low cardiac output syndrome after tricuspid valve implantation by arterial and venous femoral cannulation.The average blood flow was 45～60 mL·kg-1·min-1 and the hemodynamic parameters were steady during the ECMO period.ResultsECMO was successfully removed after 41 hours and 38 minutes.The patient had free breathing and stable vital sign after the withdrawal of cannula but died of multiple organ failure 21 days later.Conclusion ECMO is effective for burned patients with active endocarditis after performing valve implantation.It can reduce the risks in ICU.