Perioperative extracorporeal membrane oxygenation in pediatric congenital heart disease:Chinese expert consensus  

作　　者：Ru Lin Wei Wang Xu Wang Zhuo-Ming Xu Jin-Ping Liu Cheng-Bin Zhou Xiao-Yang Hong Xu-Ming Mo Shan-Shan Shi Li-Fen Ye Qiang Shu 

机构地区：[1]Department of Extracorporeal Life Support,Heart Institute,National Clinical Research Center for Child Health,Children's Hospital,Zhejiang University School of Medicine,Hangzhou,China [2]Department of Thoracic and Cardiovascular Surgery,Shanghai Children's Medical Center,Shanghai Jiao Tong University School of Medicine,Shanghai,China [3]Department of Pediatric Intensive Care Unit,National Center for Cardiovascular Disease and Fuwai Hospital,Chinese Academy of Medical Sciences,Peking Union Medical College,Beijing,China [4]Department of Cardiopulmonary Bypass,National Center for Cardiovascular Disease and Fuwai Hospital,Chinese Academy of Medical Sciences,Peking Union Medical College,Beijing,China [5]Department of Cardiovascular Surgery,Guangdong Provincial Cardiovascular Institute,Guangdong Provincial People's Hospital,Guangdong Academy of Medical Sciences,Guangzhou,China [6]Pediatric Intensive Care Unit,Faculty of Pediatrics,Chinese PLA General Hospital,Beijing,China [7]Department of Cardiothoracic,Children's Hospital of Nanjing Medical University,Nanjing,China [8]Department of CICU,Heart Institute,National Clinical Research Center for Child Health,Children's Hospital,Zhejiang University School of Medicine,Hangzhou,China [9]Department of Cardiac Surgery,National Clinical Research Center for Child Health,Children's Hospital,Zhejiang University School of Medicine,Binsheng Road 3333,Hangzhou 310052,China

出　　处：《World Journal of Pediatrics》2023年第1期7-19,共13页世界儿科杂志（英文版）

基　　金：This study was supported by“the Fundamental Research Funds for the Central Universities”(No.226-2022-00060);National Key R&D Program of China(No.2021YFC2701700).

摘　　要：Background Congenital heart disease(CHD)is one of the main supportive diseases of extracorporeal membrane oxygena-tion in children.The management of extracorporeal membrane oxygenation(ECMO)for pediatric CHD faces more severe challenges due to the complex anatomical structure of the heart,special pathophysiology,perioperative complications and various concomitant malformations.The survival rate of ECMO for CHD was significantly lower than other classifica-tions of diseases according to the Extracorporeal Life Support Organization database.This expert consensus aims to improve the survival rate and reduce the morbidity of this patient population by standardizing the clinical strategy.Methods The editing group of this consensus gathered 11 well-known experts in pediatric cardiac surgery and ECMO field in China to develop clinical recommendations formulated on the basis of existing evidences and expert opinions.Results The primary concern of ECMO management in the perioperative period of CHD are patient selection,cannulation strategy,pump flow/ventilator parameters/vasoactive drug dosage setting,anticoagulation management,residual lesion screening,fluid and wound management and weaning or transition strategy.Prevention and treatment of complications of bleeding,thromboembolism and brain injury are emphatically discussed here.Special conditions of ECMO management related to the cardiovascular anatomy,haemodynamics and the surgical procedures of common complex CHD should be considered.Conclusions The consensus could provide a reference for patient selection,management and risk identification of periop-erative ECMO in children with CHD.

关 键 词：Circulatory support Congenital heart disease Extracorporeal membrane oxygenation PEDIATRIC Respiratory support 

分 类 号：R725.4[医药卫生—儿科]