Case Report of 20 Cases of ECMO in the Treatment of Severe Adenovirus Pneumonia Complicated with ARDS

Y. Gan, Xia Chun, Jingxiang Ma, Tian Li, Wan-hua Liang, Lian-Hua Liu
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Abstract

Objective To summarize the clinical nursing experience of oxygenation (ECMO) adjuvant therapy in children with acute respiratory distress syndrome (ARDS) caused by severe adenovirus pneumonia. Method The clinical data of 20 children with severe adenovirus pneumonia complicated with ARDS who received ECMO in our hospital from April 2017 to May 2019, including general conditions, pre-treatment, complications and prognosis, were retrospectively analyzed. Results The primary disease of 20 patients was severe adenovirus pneumonia, and the average duration of ECMO treatment was [247.50(152.00,296.75)] hours. After treatment, 12 (12/20) patients successfully escaped from ECMO, 11 (11/20) patients died, and 9 (9/20) died. Complications occurred in 17 (17/20) patients with ECMO treatment. After discharge from the hospital for six months to two years, 9 patients with good quality of life, social function, normal mental development, 2 patients with ischemia and hypoxia brain damage, in the hospital or family continued rehabilitation exercise. Conclusions Children with severe adenovirus pneumonia combined with ARDS are critically ill. When other treatments are ineffective, ECMO treatment can provide cardiopulmonary support for children with reversible cardiopulmonary failure, but the complications are numerous and serious. Prevention and reduction of related complications are the key to the success of ECMO. Key words: Extracorporeal membrane oxygenation; Severe adenovirus pneumonia; Children; Acute respiratory distress syndrome
ECMO治疗重症腺病毒肺炎合并急性呼吸窘迫综合征20例报告
目的总结重症腺病毒肺炎致急性呼吸窘迫综合征(ARDS)患儿氧合(ECMO)辅助治疗的临床护理经验。方法回顾性分析2017年4月至2019年5月在我院行ECMO治疗的20例重症腺病毒肺炎合并ARDS患儿的一般情况、术前治疗、并发症及预后。结果20例患者原发疾病为重症腺病毒肺炎,ECMO治疗平均时间[247.50(152.00,296.75)]小时。治疗后ECMO成功逃脱12例(12/20),死亡11例(11/20),死亡9例(9/20)。17例(17/20)患者经ECMO治疗后出现并发症。出院后6个月至2年,9例患者生活质量良好,社会功能、智力发育正常,2例患者出现脑缺血缺氧损伤,可在医院或家庭继续进行康复锻炼。结论重症腺病毒肺炎合并ARDS患儿病情危重。当其他治疗无效时,ECMO治疗可为可逆性心肺衰竭患儿提供心肺支持,但并发症多且严重。预防和减少相关并发症是ECMO成功的关键。关键词:体外膜氧合;严重腺病毒肺炎;孩子;急性呼吸窘迫综合征
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