Disease oriented ECMO results; specific considerations for different pathologies

Ergi̇n Arslanoğlu, K. A. Kara, F. Yiğit, Babürhan Özbek, Y. Yavuz, Fatma Ukil Işıldak, E. Tunçer, N. Çine, H. Ceyran
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Abstract

Objectives: Extracorporeal membrane oxygenation (ECMO), whose use has increased with technological developments in pediatric heart surgery, is a life-saving treatment modality that is used in patients with cardiac or pulmonary insufficiency who are unresponsive to medical treatment. We investigated the effect of operation technique and cardiac morphology of patients undergoing pediatric cardiac surgery in our clinic on ECMO prognosis in this retrospective cohort study. Patients and Methods: 70 patients in need of ECMO after pediatric heart surgery were enrolled between May 2010 and April 2020 in our clinic. 44.3% (n=31) of patients were female and 55.7% (n=39) were male. Their ages ranged from 0 to 575 months, with a mean of 32.59±147.26. RACHS-1 was 25%, RACHS-2 was 23.07%, RACHS-3 was 33.33%, RACHS-4 was 35.71%, RACHS-5 was 100%, and RACHS-6 was 50% according to the ECMO result. No statistically significant difference was found between mortality and RACHS scoring. Results: As a consequence, scoring systems used in the evaluation and measurement of ECMO use in the pediatric age group can be deceptive. Conclusion: We attribute this to the fact that ECMO is a complex and complicated treatment that affects all systems in general and has a lot of mechanical and physiological complications. We think that the combination of scoring systems used in these patients with other scoring methods will give more accurate results than using them alone.
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疾病导向ECMO结果;针对不同病理的具体考虑
目的:体外膜氧合(ECMO)是一种挽救生命的治疗方式,用于对药物治疗无反应的心脏或肺功能不全患者,其应用随着儿科心脏外科技术的发展而增加。在本回顾性队列研究中,我们探讨了手术技术和心脏形态对本院儿科心脏手术患者ECMO预后的影响。患者和方法:2010年5月至2020年4月,在我诊所登记了70例小儿心脏手术后需要ECMO的患者。女性占44.3% (n=31),男性占55.7% (n=39)。年龄0 ~ 575月龄,平均32.59±147.26岁。ECMO结果显示,RACHS-1为25%,RACHS-2为23.07%,RACHS-3为33.33%,RACHS-4为35.71%,RACHS-5为100%,RACHS-6为50%。死亡率与RACHS评分之间无统计学差异。结果:因此,用于评估和测量ECMO在儿科年龄组使用的评分系统可能具有欺骗性。结论:我们认为这是因为ECMO是一种复杂的治疗方法,一般会影响所有系统,并有许多机械和生理并发症。我们认为,在这些患者中使用的评分系统与其他评分方法的组合将比单独使用它们提供更准确的结果。
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