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급성호흡부전 환아에게 이중관 캐뉼라로 시행한 정맥간 체외막형산화장치

Veno-venous Extracorporeal Membrane Oxygenation with a Double Lumen Catheter for Pediatric Pulmonary Support

  • 최민석 (성균관대학교 의과대학 삼성서울병원 흉부외과학교실) ;
  • 양지혁 (성균관대학교 의과대학 삼성서울병원 흉부외과학교실) ;
  • 전태국 (성균관대학교 의과대학 삼성서울병원 흉부외과학교실) ;
  • 이영탁 (성균관대학교 의과대학 삼성서울병원 흉부외과학교실) ;
  • 안강모 (성균관대학교 의과대학 삼성서울병원 소아청소년과학교실)
  • Choi, Min-Suk (Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Yang, Ji-Hyuk (Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Jun, Tae-Gook (Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Lee, Young-Tak (Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Ahn, Kang-Mo (Department of Pediatrics, Sansung Medical Center, Sungkyunkwan University School of Medicine)
  • 투고 : 2009.09.25
  • 심사 : 2009.10.20
  • 발행 : 2010.04.05

초록

말초혈관 삽관을 통한 체외막형산화장치가 도입된 후, 국내에서도 체외막형산화장치의 적용 사례가 빠르게 증가하고 있다. 하지만 소아에서는 아직까지 그 사용이 제한적인데, 그 이유는 소아에 적합한 장비가 공급되지 않고, 소아의 특성 상 말초혈관을 통한 삽관으로 충분히 보조하기 어렵기 때문이다. 이로 인해 국내에서 발표된 소아의 체외막형산화장치 적용 사례는 주로 심장수술 후 보조 목적으로, 정맥-동맥 간에 사용된 것이었다. 최근 저자들은 호흡부전증후군 소아를 대상으로 하나의 이중관 캐뉼라를 경피적으로 내경정맥에 삽관하여 성공적으로 정맥간 체외막형산화장치를 시행하였기에 이를 보고하는 바이다.

The number of cases of extracorporeal membrane oxygenation (ECMO) has rapidly increased all over Korea since the introduction of peripheral cannulation catheters. However, the application of ECMO to children has been limited due to the shortage of pediatric equipment and difficulty in maintaining an ECMO system with peripheral cannulation. For this reason, there have been only few reports of pediatric ECMO in Korea, and most of them pertained to the veno-arterial type ECMO for supporting the cardiac system in postcardiotomy patients. We report here on the successfully performing veno-venous ECMO, with using a double lumen percutaneous catheter, in a child with acute respiratory distress syndrome.

키워드

참고문헌

  1. Lee KH, Lee SM, Chung YK, et al. Prolonged extracorporeal lung heart assist (Extracorporeal Membrane Oxygenation) - 4 cases report. Korean J Anesthesiol 1992;25:424-32 https://doi.org/10.4097/kjae.1992.25.2.424
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  4. Yang HC, Lee YT, Sung K, et al. Short-term mechanical circulatory support with centrifugal pump in cardiac arrest or cardiogenic shock: report of 5 cases. Korean J Thorac Cardiovasc Surg 2004;37:1003-9
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  6. Meuers KV, Lally KP, Peek G, Zwischenberger JB. ECMO:Extracorporeal cardiopulmonary support in critical care. 3rd ed. Ann Arbor, Michigan: Extracorporeal Life Support Organization. 2005
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  8. Lee KH, Kim KW. The effect of venovenous extracorporeal lung assist on the oxygenation of mixed venous blood: Comparison of venovenous bypass using a dulble lumen tube with that using two catheters. Korean J Anesthesiol 1991;24:1-10 https://doi.org/10.4097/kjae.1991.24.1.1

피인용 문헌

  1. Outcomes of Extracorporeal Membrane Oxygenation in Children: An 11-Year Single-Center Experience in Korea vol.50, pp.5, 2010, https://doi.org/10.5090/kjtcs.2017.50.5.317