Application of extracorporeal membrane oxygenation in the treatment of persistent pulmonary hypertension of the newborn / 中国当代儿科杂志

OBJECTIVES@#To study the clinical value of extracorporeal membrane oxygenation (ECMO) in the treatment of persistent pulmonary hypertension of the newborn (PPHN).@*METHODS@#A retrospective analysis was performed on the medical data of 11 neonates with PPHN who were treated with ECMO in the Neonatal Intensive Care Unit of Zhongshan People's Hospital from January 2015 to December 2021, involving the neonates' general information, clinical diagnosis, laboratory results, duration of ECMO treatment, complications during ECMO treatment, length of hospital stay, and outcome.@*RESULTS@#Of the 11 neonates, 10 (91%) had successful weaning from ECMO, and 8 (73%) survived. For the 11 neonates, the mean duration of ECMO treatment was (81±50) hours (range: 26 to 185 hours), the mean duration of ventilator use was (198±105) hours (range: 57 to 392 hours), and the mean length of hospital stay was (22±15) days (range: 2 to 49 days). The oxygenation index and blood lactate level were significantly improved after 24 hours of ECMO treatment among the 11 neonates (P<0.05). Ten neonates had significantly reduced pulmonary artery pressure after 24 hours of ECMO treatment (P<0.05). One neonate had a progressive increase in the pulmonary artery pressure during EMCO treatment, succumbing to death. This neonate was diagnosed with alveolar capillary dysplasia based on the histopathological findings of the lung tissue and whole-exome sequencing results. Among the 11 children, 5 had intracranial hemorrhage, 1 had disseminated intravascular coagulation, 1 had gastric hemorrhage, 2 had pulmonary hemorrhage, 1 had renal insufficiency, and 3 had bleeding at the puncture site during ECMO treatment.@*CONCLUSIONS@#ECMO is effective for the treatment of PPHN, however, the high incidence of complications of ECMO treatment suggests that it is important to carefully assess the indications and timing of ECMO treatment and improve the management of ECMO, which can improve the weaning rate and survival rate.

Effect of plasmaslyte A on the liver function of patients undergoing cardiac surgery with extracorporeal circulation / 南方医科大学学报

<p><b>OBJECTIVE</b>To observe the effect of plasmaslyte A on the liver function of patients receiving cardiac surgery with extracorporeal circulation.</p><p><b>METHODS</b>Sixty patients scheduled for cardiac surgery were randomized to receive plasmaslyte A (group P, n=30) and ringer lactate solution (group R, n=30). The two agents were used in priming heart-lung machine and intra- and postoperative crystal solution. All the patients were examined for the levels of AST, ALT and Lac the day before and at 2 h and 1, 3 and 7 days after the surgery. The time of extubation and length of stay at the ICU were record.</p><p><b>RESULTS</b>The levels of ALT, AST and Lac in group P were significantly lower than those in group R (P<0.05), and the duration of intubation and stay at the ICU was shorter in group P (P<0.05).</p><p><b>CONCLUSION</b>Plasmaslyte A can markedly reduce the level of AST, ALT and Lac and protect the liver function of patients undergoing cardiac surgery with extracorporeal circulation.</p>