体外膜肺氧合在成人心脏手术术后心力衰竭治疗中的应用

目的:观察体外膜肺氧合(extracorporeal membrane oxygenation,ECMO)对成人心脏手术术后心力衰竭患者的治疗效果,探讨在此类患者应用ECMO的适应证。方法:自2006年11月—2007年1月,对3例成人心脏术后心力衰竭的患者进行ECMO支持治疗,均采用股动-静脉插管。ECMO期间维持血流动力学和呼吸指标稳定。结果:ECMO时间平均102.3h。3例患者心功能改善、均顺利脱机。1例康复出院,1例脱机31d后因严重肺部感染死亡,1例脱机5d后因心律失常死亡。结论:ECMO是治疗成人心脏术后心功能衰竭的有效方法,但需正确掌握适应证,合理选择患者。

Application of Extracorporeal Membrane Oxygenation for Heart Failure after Cardiac Procedure in the Adult

Objective:To evaluate the clinical effect of extracorporeal membrane oxygenation (ECMO) support for heart failure after cardiac procedure in the adult and summarize the experience in selecting patients.Methods:From December 2006 to January 2007, 3 patients undergoing cardiac procedure with postoperative heart failure received ECMO support. ECMO was established in all patients by cannulation of femoral artery and femoral vein. The hemodynamic and respiratory parameters were maintained stabilization. Results: Mean duration of ECMO was 102.3 h. All patients were successfully weaned from ECMO. After weaning, one patient recovered while two patients died of pulmonary infection and arrhythmia respectively.Conclusion:ECMO is an effective technique to treat heart failure after cardiac procedure in the adult, although selection of patients is a more important consideration.