Servet ERGÜN, Okan YILDIZ, Mustafa GÜNEŞ, Shiraslan BAKSHALİYEV, Erkut ÖZTÜRK, İsmihan Selen ONAN, Alper GÜZELTAŞ, Sertaç HAYDİN

Use of A New Extracorporeal Membran Oxygenator System and First Experiences

Objective: In this study, we aimed to share our first experiences about the extracorporeal membrane oxygenator (ECMO) system that we have just started to use and compare it with the system we used before.Methods: Between January 2019 and December 2019, 27 consecutive patients under the age of 18 who were operated for congenital heart disease and needed ECMO support were retrospectively analyzed. İn this period The Medos Deltastream diagonal pump and Sorin Revolution ECMO systems were used.Results: Successful wean was observed in six (42.9%) patients in Medos ECMO group and two (15.4%) in Sorin ECMO group. Five (35.7%) patients discharged in the Medos ECMO group. In Sorin ECMO group all patients died. The difference between the groups in terms of the number of patients discharged was statistically significant (p = 0.02). Lactate clearance was 14 hours in Medos ECMO and 48 hours in Sorin ECMO (p = 0.02).Conclusion: In this study, in which we shared our first experiences regarding the first use of the Sorin ECMO system in the postcardiac pediatric patient group, we observed slower lactate clearance, lower succesful wean and higher mortaly rates. Therefore, this should be taken into account during the use of this system.

Farklı Bir Pediyatrik Extrakorporeal Membran Oksijenatör Sistemine Geçiş ve İlk Tecrübeler

Giriş: Çalışmamızda yeni kullanmaya başladığımız extracorporeal membran oksijenatörü (ECMO) sistemi ile ilgili ilk tecrübelerimizi paylaşmak ve daha önce kullandığımız sistem ile kıyaslamayı amaçladık. Yöntemler: Ocak 2019 ile Aralık 2019 tarihleri arasında kliniğimizde konjenital kalp hastalığı nedeni ile opere edilmiş ve sonrasında ECMO desteği ihtiyacı olmuş 18 yaş altı 27 ardışık hasta retrospektif olarak incelenmiştir. Belirtilen tarih aralığında The Medos Deltastream diagonal pump ve Sorin Revolution sistemi kullanılmıştır. Bulgular: Medos ECMO kullanılan grupta başarılı wean altı (%42.9) hastada gözlenirken, Sorin ECMO kullanılan grupta iki (%15.4) olarak saptandı. Taburcu edilen hasta sayısı ise Medos ECMO kullanılan grupta beş (%35.7) olarak saptandı. Sorin ECMO kullanılan hastaların tamamının ex olduğu gözlendi. Taburcu edilen hasta sayısı açısından gruplar arası fark istatistiksel anlamlı idi (p=0.02). Laktat klirensi Medos ECMO’ de 14 saat iken, Sorin ECMO’ da 48 saat olarak saptandı (p=0.02). Sonuç: Sorin ECMO sisteminin postkardiyotomi pediatric hasta grubunda kullanımına ilişkin ilk tecrübelerimizi paylaştığımız çalışmamızda, bu sistemde daha yavaş laktat klirensi, daha az başarılı wean ve daha az taburculuk oranları gözlemledik. Bu yüzden bu sistemin kullanılması sırasında bu faktörlerin göz önüne alınması gerektiği görüşündeyiz.

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