先天性横隔膜ヘルニアにおけるECMOの利用 : 救命例の報告と文献的考察

概要

論文の詳細を見る
A case of congenital diaphragmatic hernia successfully treated by ECMO was reported. A female baby, weighing 3,468g at birth, was transferred to our hospital because of respiratory distress which started immediately after birth. Her left diaphragmatic hernia was repaired through the abdomen at 5 hours after birth. She belonged to the third group according to our classification, because her AaDO_2 level was 650mmHg on admission and 672mmHg after the operation. She temporarily recovered from persistent fetal circulation (PFC) at 12 hours of age by respiratory care and administration of tolazoline. But, after 9 hours, she reverted into PFC again which could not be controlled by any other therapeutic methods. ECMO was started at 59 hours after birth and the maximum flow rate was 312 ml/min (92ml/kg/min). Since her general condition had improved after ECMO was started, the setting of the respirator was decreased into FiO_2: 0.4, PIP: 20cmH_2O, Rate: 10times/min. 60 hours after the start of ECMO, it was weaned and the patient was converted to conventional respiratory care, which was discontinued when the patient was 13-day-old. There have been many cases where respiratory distress was successfully treated by ECMO in the world literature, but this case seems to be the first newborn case in Japan.
日本小児外科学会の論文
1987-05-20