| Japanese |
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| Title | 小児での各種循環補助手段 |
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| Subtitle | 特集 |
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| Authors | 平田隆彦*, 公文啓二*, 杉本久*, 西垣恭一**, 笹子佳門**, 妙中義之***, 中谷武嗣***, 道井洋吏**, 鬼頭浩之**, 八木原俊克**, 高野久輝***, 川島康生** |
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| Authors(kana) | |
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| Organization | *国立循環器病センター外科系集中治療科, **国立循環器病センター心臓外科, ***国立循環器病センター研究所 |
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| Journal | 循環制御 |
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| Volume | 12 |
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| Number | 4 |
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| Page | 639-644 |
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| Year/Month | 1991/ |
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| Article | 報告 |
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| Publisher | 日本循環制御医学会 |
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| Abstract | 「要旨」当センターにおける小児でのIABP, LVAS, VAB(V-A ECMO)の経験を報告した. 小児・乳児用の小容量のIABPバルーンの性能は向上しており, 適切なバルーンを用いることで小児においてもIABPにより十分な循環補助効果を得ることが出来ると思われる. 2例の小児症例において体外循環離脱困難のためLVASを使用した. 両症例とも術後急性期はLVASに依存していたが, 急速に心機能の回復を見て, LVASより離脱できた. LVASは小児に対して有効であると思われた. 小型人工肺とBiopumpを組み合わせ, 全体の充填量が170mlの閉鎖回路を作成し, 生後11ヶ月, 体重6.3kgの患児にV-A ECMOを行った. VABは治療手段として見直す余地があるものと思われた. 「はじめに」循環補助手段として現在成人では, 大動脈内バルーンパンピング(Intra-Aortic Balloon Pumping, IABP), 左心室補助装置(Left Ventricular Assist System, LVAS), 静・動脈バイパス(Veno-Arterial Bypass, VAB)などが用いられているが, 小児における経験は成人と比べて少なくまた成績も決して良くはない. ここでは当センターでの小児におけるこれら三種類の循環補助手段の経験を報告する. |
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| Practice | 基礎医学・関連科学 |
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| Keywords | |
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| English |
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| Title | Assisted circulation for pediatric cases |
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| Subtitle | |
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| Authors | Takahiko Hirata*, Keiji Kumon*, Hisashi Sugimoto*, Kyoich Nishigaki**, Yoshikado Sasako**, Yoshiyuki Taenaka***, Takeshi Nakatani***, Hiroshi Doi**, Hiroyuki Kito**, Toshikatsu Yagihara**, Hisateru Takano***, Yasunaru Kawashima** |
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| Authors(kana) | |
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| Organization | *National cardio vascular Center Surgical Intensive Care Unit, **National cardio vascular Center Cardiovascular Surgery, ***National cardio vascular Center Research Institute |
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| Journal | Circulation Control |
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| Volume | 12 |
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| Number | 4 |
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| Page | 639-644 |
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| Year/Month | 1991/ |
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| Article | Report |
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| Publisher | Japan Society of Circulation Control |
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| Abstract | Our experience of circulatory support in infants and children was reported. Intra-aortic balloon pumping (IABP)：IABP has been thought to be less effective in infants and children than in adults because of the high elasticity of the aorta of children and the lack of the good equipment for pediatric use. The improvement of the IABP balloon has made it possible to use IABP in infants and children, if appropriately sized balloon catheters are selected. Left ventricular assist system (LVAS)：The pediatric LVAS was clinically used in two children after the open heart surgery. In each case, no arterial pressure waveform produced by the natural heart could be observed during the early postoperative period, but the natural heart recovered quickly and the LVAS could be removed within a week. LVAS will become a promising therapeutic modality for management of severe pediatric heart failure. Veno-arterial bypass (VAB)：A newly developed membrane oxygenator combined with a Biopump was used for VAB. The system was so compact that the priming volume of the closed circuit was only 170 ml, The ability of the membrane oxygenator to add oxygen and to remove carbon dioxide was well maintained on the 7th day after the bypass started. VAB can become an effective method as assist circulation in infants and children. |
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| Practice | Basic medicine |
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| Keywords | |
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