Veno-Venous Extra-Corporeal Membrane Oxygenation (ECMO) in a Child with Hemoptysis and Fontan Circulation

• 作者: Anais Mons Claude Marcus Claudine Kumba Emre Belli Francis Grossenbacher Gauthier Loron Jean-Marc Malinovsky Nathalie Bednarek-Weirauch Pierre Mauran Vito Giovanni Ruggieri
• 来源期刊: 儿科学期刊(英文)
• 学科: 医学
• 关键词: Extracorporeal Membrane Oxygenation Fontan Circulation Univentricular Heart Tricuspid Atresia Children One Lung Ventilation Mobile ECMO Team Pediatric Anesthesia and Critical Care Angio-Embolization Interventional Radiology Pediatric Cardiology Pediatric Cardiac Surgery Trans-Thoracic Echocardiography Aortic Velocity Time Integral Fluid Responsiveness Goal Directed Fluid and Hemodynamic Therapy
• 年，卷（期）: 2020,（2）
• 页码范围: 280-287
• 页数: 8页
• 分类号: R65

摘要

<u>Background:</u><span style="font-family:Verdana;"> Extracorporeal</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">membrane oxygenation is a rescue life support technique used in life threatening</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">conditions of refractory respiratory and/or cardiac distress. Indication for extracorporeal life support in children</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">depends on age and varies from pulmonary to cardiac pathologies. In some cases</span><span style="font-family:Verdana;">,</span><span style="font-family:Verdana;"> it may be used as a bridge to a</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">therapeutic procedure.</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">We described here the management of respiratory failure due to hemoptysis in a child with a Fontan circulation</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">and veno-venous extracorporeal membrane oxygenation which served as a bridge to angio-embolization. Hemoptysis can be a life threatening condition which can lead to hypovolemic shock and impaired alveolar gas</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">exchange. The latter can result in respiratory failure and consequent asphyxia.</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">When hemoptysis occurs in a patient with a univentricular</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">heart and a Fontan circulation, management of this</span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">clinical situation can be challenging due to the particular physiology of the latter. Total cavopulmonary connection is a palliative surgical repair which constitutes Fontan circulation as a definitiv