Extracorporeal lung assist with a heparin-bonded bypass circuit for meconium aspiration syndrome.

概要

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We applied extracorporeal lung assist (ECLA) with a heparin-bonded (Carmeda BioActive SurfaceTM) bypass circuit to a full-term newborn male, weighing 3, 324g, suffering from severe respiratory failure due to meconium aspiration syndrome. Veno-arterial ECLA with a minimax plusTM oxygenator via the right internal jugular vein and the right common carotid artery was initiated 55 hours after birth. Heparin was administered as a bolus of 100IU·kg-1 prior to cannulation, and continued at 3 to 15IU·kg-1·min-1 to maintain an activated coagulation time (ACT) of 120-160 seconds. The oxygenator was changed once during the treatment because of plasma leakage. The patient was weaned from ECLA 89 hours and 25 minutes after initiation. He was weaned from the ventilator 7 days after the termination of ECLA and discharged on the 53rd hospital day. The amount of heparin required for anticoagulation was reduced with the use of a heparin-bonded circuit. However, the disadvantage of a heparin-bonded membrane oxygenator is plasma leakage which results in impairment of gas exchange.
一般社団法人日本集中治療医学会の論文