RESUMO
UNLABELLED: Extracorporeal life support (ECLS) is used in pediatric patients with ARDS in recent 20 years with survival rate from 50 to 67% Venovenous ECLS was used in 1 year 2 months old patient with ARDS and pneumonia developed in postoperative period after gastral esophagoplasty. Purposes of ECLS use were stabilization child's condition and normalization of gas composition of blood with relative lungs repose. Indications for ECLS were increasing respiratory failure, hypoxemia, low respiratory index (PaO2/FiO2 ratio 47.3), alveolar-arterial gradient of oxygen (A-aDO) 630 mmHg and absence of positive effect from high frequency oscillation (HFO). MATERIALS AND METHODS: ECLS was used in 1 year 2 months old patient with ARDS and bilateral pneumonia developed in postoperative period after gastral esophagoplasty. Deltasteam system (Medos Medizintechnik AG, Germany) with centrifugal pump and servoregulation of blood flow pressure was used for ECLS. Double-lumen cannula with size 12 French was used ECLS was instituted via right internal jugular vein. RESULTS: The patient did not have expressed heart failure. Thus preference was given to venovenous ECLS and not to venoarterial ECLS. Duration of ECLS use was 72 hours. Auscultation parameters and gas exchange improved haemodynamics stabilized parameters of biochemical and haematological analysis normalized and the dynamics x-ray examination was positive after the ECLS use. Patient was decannulated and extubated. CONCLUSIONS: Venovenous ECLS was an only way of life support in child with heavy ARDS and pneumonia developed in postoperative period More observations are needed for more thorough analysis and recommendations.
Assuntos
Oxigenação por Membrana Extracorpórea/métodos , Hemofiltração/métodos , Pneumonia/terapia , Complicações Pós-Operatórias/terapia , Síndrome do Desconforto Respiratório/terapia , Esofagoplastia , Feminino , Humanos , Lactente , Pneumonia/complicações , Pneumonia/diagnóstico , Complicações Pós-Operatórias/etiologia , Síndrome do Desconforto Respiratório/complicações , Síndrome do Desconforto Respiratório/diagnóstico , Resultado do TratamentoRESUMO
The thoracoscopic and traditional thoracotomic surgical access for bronchiectesis treatment in children were compared. The first (thoracoscopic) group included 18 children. The control (thoracotomic) group included 26 patients. The mean operative time in the 1st group was 78.3±31 min; pleural draining lasted for 1.3 days and postoperative hospital stay was 9.93±2.08 days. The mean operative time in the 2nd group was 81.7±35.1 min; pleural draining lasted for 3.3 days and postoperative hospital stay was 14.4±3.4 days. Conversion was needed in 4 cases. Therefor, the thoracoscopic surgery proved to be much more preferable in children because of its' minimal invasiveness.
Assuntos
Bronquiectasia/cirurgia , Pneumonectomia , Complicações Pós-Operatórias/prevenção & controle , Toracoscopia , Toracotomia , Adolescente , Bronquiectasia/diagnóstico , Bronquiectasia/etiologia , Broncografia/métodos , Criança , Pré-Escolar , Pesquisa Comparativa da Efetividade , Feminino , Humanos , Pulmão/diagnóstico por imagem , Pulmão/cirurgia , Masculino , Pneumonectomia/efeitos adversos , Pneumonectomia/métodos , Cuidados Pós-Operatórios/métodos , Estudos Retrospectivos , Toracoscopia/efeitos adversos , Toracoscopia/métodos , Toracotomia/efeitos adversos , Toracotomia/métodos , Tomografia Computadorizada Espiral/métodos , Resultado do TratamentoRESUMO
The aortic arch and its branches anomalia compound 1-3.8% of all vessel inborn diseases. The treatment of such anomalia as tracheal vessel ring aims the liquidation of esophageal and tracheal compression. The authors introduce their experience of thoracoscopic tracheal vessel rings resection in 6 children. The time of the operation was 145±15min. There were no conversions to the traditional open surgery. The result was excellent in 4 of 6 children, who were completely releaed of tracheal obstruction symptoms. The rest 2 children demonstrated mild respiratory symptoms, cuased by the tracheomalation.
