Ying Liyang,Qi Jianchuan,Liu Xiwang,et al.Application of cervical intubation for severe diseases by extracorporeal membrane oxygenation in children[J].Journal of Clinical Pediatric Surgery,,19():926-929.[doi:10.3969/j.issn.1671-6353.2020.10.012]
Application of cervical intubation for severe diseases by extracorporeal membrane oxygenation in children
- CLC:
- R651.4
- Abstract:
- Objective To summarize and discuss the application of right carotid artery and internal jugular vein cannulation in extracorporeal membrane oxygenation (ECMO) in children.Methods A total of 70 ECMO children were recruited from November 2009 to February 2019.And disease type,age,weight,ECMO time,complications and prognosis were analyzed.Results All children underwent ECMO via right cervical cannulation.There were 39 boys and 31 girls.All of them underwent right carotid artery and internal jugular vein incision and intubation under sufficient sedation,pain relief,muscle relaxation and ventilator supports.Three cases failed while the others succeeded in intubation.In 3 cases,distal intubation of incision was enlarged due to venous stenosis.One case of neonatal vein was torn and enlarged with distal vein intubation and another case of hoarseness occurred due to vagus nerve injury.Two cases of intubation were adjusted due to a poor position of intubation tip and one case with thrombus at the intubation head was replaced with new intubation.And 18 cases were intubated under cardiopulmonary resuscitation (CPR).V-A mode was employed for all ECMO children.The operative duration of intubation was (41.1±32.3) min,the time of ECMO running (167.5±133.5) hours and the median operative duration 120 hours.Fifty-one patients were successfully weaned and proximal end of carotid artery was ligated upon ECMO weaning.Conclusion Right carotid artery and internal jugular vein incision and intubation is safe,effective and reliable for pediatric ECMO.However,the learning curve of intubation under CPR remains long.
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Memo
收稿日期:2019-06-27。
基金项目:浙江省医药卫生科技计划（编号：2015KYB193）
通讯作者:舒强,Email:shuqiang@zju.edu.cn