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물놀이 사고로 유발된 급성호흡부전 환자에서 정정맥 체외순환막형산화요법의 적용 - 2예 보고 -

Veno-Venous Extracorporeal Membrane Oxygenation of Acute Respiratory Failure due to Near-drowning -2 case reports-

  • 김형수 (한림대학교 의과대학 흉부외과학교실) ;
  • 한상진 (한림대학교 춘천성심병원 순환기내과) ;
  • 이창률 (한림대학교 춘천성심병원 호흡기내과) ;
  • 이순희 (한림대학교 춘천성심병원 전임간호사) ;
  • 정재한 (한림대학교 의과대학 흉부외과학교실) ;
  • 김성준 (한림대학교 의과대학 흉부외과학교실)
  • Kim, Hyoung-Soo (Department of Thoracic and Cardiovascular Surgery, College of Medicine Hallym University) ;
  • Han, Sang-Jin (Department of Cardiology, Chuncheon Sacred Heart Hospital, Hallym University) ;
  • Lee, Chang-Youl (Department of Pulmonology, Chuncheon Sacred Heart Hospital, Hallym University) ;
  • Lee, Sun-Hee (Advanced Practice Nurse of Thoracic and Cardiovascular Surgery, Chuncheon Sacred Heart Hospital, Hallym University) ;
  • Jung, Jae-Han (Department of Thoracic and Cardiovascular Surgery, College of Medicine Hallym University) ;
  • Kim, Sung-Jun (Department of Thoracic and Cardiovascular Surgery, College of Medicine Hallym University)
  • 투고 : 2009.10.26
  • 심사 : 2009.11.24
  • 발행 : 2010.04.05

초록

여러 가지 원인에 의해 발생된 급성 호흡부전에서 체외순환막형산화요법은 폐기능을 회복시키는데 도움이 될 수 있다. 물놀이 사고로 인해 발생된 급성 호흡부전 환자에서 기존의 적절한 치료에 반응하지 않는 경우 체외순환막형산화요법으로 성공적으로 치료한 보고들이 있다. 저자들은 물놀이 사고로 급성호흡부전이 발생한 2명의 환자를 정정맥 체외순환막형산화요법으로 치료를 하였다. 정맥 도관의 삽입은 모두 경피적으로 양측 대퇴정맥을 이용하였다. 2명의 환자 모두 성공적으로 체외순환막형산화요법을 제거할 수 있었으나, 1명의 환자에서 저 산소성 뇌손상과 거미막 및 출혈이 발생하였다.

Extracorporeal membrane oxygenation (ECMO) during acute respiratory failure due to any cause aids in the recovery of respiratory function. The use of ECMO for acute respiratory failure due to near drowning was reported to be a successful therapeutic option in those patients who do not respond to optimal conventional therapies. We performed veno-venous ECMO for 2 acute respiratory failures due to near-drownings. All cannulations were performed percutaneously via both femoral veins. The 2 patients were successfully weaned off ECMO, but one patient experienced diffuse hypoxic brain damage and a subarachnoid hemorrhage.

키워드

참고문헌

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