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

World Journal of Pediatrics 2023年第1期19卷 7-19页

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 Department of Extracorporeal Life support Heart InstituteNational Clinical Research Center for Child HealthChildren's HospitalZhejiang University School of MedicineHangzhouChina Department of Thoracic and Cardiovascular Surgery Shanghai Children's Medical CenterShanghai Jiao Tong University School of MedicineShanghaiChina Department of Pediatric Intensive Care Unit National Center for Cardiovascular Disease and Fuwai HospitalChinese Academy of Medical SciencesPeking Union Medical CollegeBeijingChina Department of Cardiopulmonary Bypass National Center for Cardiovascular Disease and Fuwai HospitalChinese Academy of Medical SciencesPeking Union Medical CollegeBeijingChina Department of Cardiovascular Surgery Guangdong Provincial Cardiovascular InstituteGuangdong Provincial People's HospitalGuangdong Academy of Medical SciencesGuangzhouChina Pediatric Intensive Care Unit Faculty of PediatricsChinese PLA General HospitalBeijingChina Department of Cardiothoracic Children's Hospital of Nanjing Medical UniversityNanjingChina Department of CICU Heart InstituteNational Clinical Research Center for Child HealthChildren's HospitalZhejiang University School of MedicineHangzhouChina Department of Cardiac Surgery National Clinical Research Center for Child HealthChildren's HospitalZhejiang University School of MedicineBinsheng Road 3333Hangzhou 310052China

Background Congenital heart disease(CHD)is one of the main supportive diseases of extracorporeal membrane oxygena-tion in *** 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 *** survival rate of ECMO for CHD was significantly lower than other classifica-tions of diseases according to the Extracorporeal Life support Organization *** expert consensus aims to improve the survival rate and reduce the morbidity of this patient population by standardizing the clinical *** 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 *** 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 *** and treatment of complications of bleeding,thromboembolism and brain injury are emphatically discussed *** conditions of ECMO management related to the cardiovascular anatomy,haemodynamics and the surgical procedures of common complex CHD should be *** 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

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