Extracorporeal membrane oxygenation (ECMO) in neonatal respiratory failure. 100 cases.
AUTOR(ES)
Bartlett, R H
RESUMO
Extracorporeal membrane oxygenation (ECMO) was used in the treatment of 100 newborn infants with respiratory failure in three phases: Phase I (50 moribund patients to determine safety, efficacy, and risks); Phase II (30 high risk patients to compare ECMO to conventional ventilation); and Phase III (20 moderate to high risk patients, the current protocol). Seventy-two patients survived including 54% in Phase I, 90% in Phase II, and 90% in Phase III. The major complication was intracranial bleeding, which occurred in 89% of premature infants (less than 35 weeks) and 15% of full-term infants. Best survival results were in persistent fetal circulation (10, 10 survived), followed by congenital diaphragmatic hernia (9, 7 survived), meconium aspiration (44, 37 survived), respiratory distress syndrome (26, 13 survived), and sepsis (8, 3 survived). There were seven late deaths; in follow-up, 63% are normal or near normal, 17% had moderate to severe central nervous system dysfunction, and 8% had severe pulmonary dysfunction. ECMO is now used in several neonatal centers as the treatment of choice for full-term infants with respiratory failure that is unresponsive to conventional management. The success of this technique establishes prolonged extracorporeal circulation as a definitive means of treatment in reversible vital organ failure.
ACESSO AO ARTIGO
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1251270Documentos Relacionados
- Successful extracorporeal membrane oxygenation (ECMO) support for fulminant community-acquired pneumococcal pneumonia.
- Extracorporeal membrane oxygenation for severe acute respiratory failure
- Extracorporeal Membrane Oxygenation (ECMO) Training Program in A Pediatric Cardiac Intensive Care Unit: An 8-Year Single-Center Experience in Argentina
- Extracorporeal life support for 100 adult patients with severe respiratory failure.
- Extracorporeal life support for neonatal respiratory failure. A 20-year experience.