CAJ | 학술논문

目的探讨体外膜肺氧合(ECMO)技术用于潜在心脏死亡供者院间转运的管理方法及效果.方法 8例脑外伤后中枢性循环衰竭的潜在心脏死亡供者在ECMO的支持下通过救护车进行院间转运,选择一侧使用美敦力整体股动、静脉插管,在直视下置管,超声确定静脉前端位于下腔静脉入心房处,动脉前端位于肾动脉开口下方,置管前给予肝素100 IU/kg静脉注射,流量维持在2.0～3.0 L/min,纯氧通气2～3 L/min,待血流动力学平稳,将患者带ECMO移入救护车,进行转运.结果 8例潜在心脏死亡供者全部成功转运,转运里程超过100 km,平均体外膜肺氧合运转时间为120min,转流过程循环稳定,到达目的医院后,按心脏死亡器官捐赠流程实施了器官捐赠.成功获得8个肝脏和8对肾脏,移植给24例受者.结论 ECMO可以确保风险极大的潜在心脏死亡供者安全进行院间转运,顺利完成器官捐赠.
목적 탐토체외막폐양합(ECMO)기술용우잠재심장사망공자원간전운적관리방법급효과.방법 8례뇌외상후중추성순배쇠갈적잠재심장사망공자재ECMO적지지하통과구호차진행원간전운,선택일측사용미돈력정체고동、정맥삽관,재직시하치관,초성학정정맥전단위우하강정맥입심방처,동맥전단위우신동맥개구하방,치관전급여간소100 IU/kg정맥주사,류량유지재2.0～3.0 L/min,순양통기2～3 L/min,대혈류동역학평은,장환자대ECMO이입구호차,진행전운.결과 8례잠재심장사망공자전부성공전운,전운리정초과100 km,평균체외막폐양합운전시간위120min,전류과정순배은정,도체목적의원후,안심장사망기관연증류정실시료기관연증.성공획득8개간장화8대신장,이식급24례수자.결론 ECMO가이학보풍험겁대적잠재심장사망공자안전진행원간전운,순리완성기관연증.
Objective To discuss Extracorporeal Membrane Oxygenation(ECMO) management method and effect during inter-hospital transport of potential cardiac death donors after cardiac death (DCD).Methods 8 potential donors after cardiac death with brain injury were supported by ECMO for inter-hospital transport.All donors were inserted Medtronic overall cannula into one side femoral artery and venous.The position of catheters were guided by ultrasound.The front-end of venous catheter located in the junction of atrium and inferior vena cava,meanwhile the front-end of artery catheter was below renal artery.100 IU/kg heparin was injected before inserting cannulas.Flow of ECMO maintained at 2.0～3.0 L/min,and oxygen flow was 2～3 L/min during ECMO supporting.When hemodynamics of potential donors were stable,patients were moved into ambulance with ECMO for inter-hospital transport.Results A total of 8 ECMO transports were performed for central circulatory collapse caused brain injury.Patients were previously cannulated and on ECMO prior to transport and transported a distance of more than 100 kilometer from our institution by ambulance.ECMO running times were 120 min,and operation process circulatory stable.Conclusion ECMO can ensure inter-hospital transport of potential donors after cardiac death safety.