首页|3例应用ECMO联合连续性肾脏替代疗法救治脓毒症合并爆发性心肌炎患儿的护理

3例应用ECMO联合连续性肾脏替代疗法救治脓毒症合并爆发性心肌炎患儿的护理

扫码查看
目的 总结 3 例应用体外膜肺氧合(extracorporeal membrane oxygenation,ECMO)联合连续性肾脏替代疗法(continuous renal replacement therapy,CRRT)救治脓毒症合并爆发性心肌炎(fulminant myocarditis,FM)患儿的护理经验.方法 回顾本科室收治的 3 例脓毒症合并爆发性心肌炎患儿联合ECMO、呼吸机辅助呼吸及CRRT的治疗过程,护理方面密切观察病情变化,给予的相关护理包括ECMO转速、流量及压力监测、管道固定、抗凝管理、ECMO串联CRRT的护理、镇静镇痛管理、体温管理及并发症预防等.结果 3 例患儿经ECMO联合呼吸机辅助呼吸及CRRT等紧急抢救治疗及护理后,生命体征和血流动力学逐渐稳定,顺利撤除ECMO,成功转出儿科监护室(pediatric intensive care unit,PICU).结论 在ECMO救治脓毒症并爆发性心肌炎患儿的护理过程中,护理人员做好病情观察变化及ECMO相关护理、ECMO串联CRRT的护理等,方可配合医生完成抢救工作,提高患者ECMO治疗后存活率.
Nursing care of children on ECMO due to sepsis shock and complicated with fulminant myocarditis:a report of 3 cases
Objective To summarise a clinical experience of nursing care for 3 children who were treated with ECMO for sepsis and complicated with fulminant myocarditis.Methods Clinical data in nursing cares for 3 children treated with ECMO for sepsis and complicated with fulminant myocarditis were collected and analysed,with the spotted difficulties in nursing care and proposed coping strategies.Results The 3 children survived and were transferred out of the(pediatric intensive care unit,PICU)with stable vital signs and haemodynamics after emergency treatment with ECMO and continuous renal replacement therapy(CRRT).Conclusion Children with sepsis leading to myocardial depression and subsequent heart failure require close observation of the changes and consequently specialised cares after having initiated an ECMO in emergency treatment.This includes ensuring proper fixation of the cannulas,managing anticoagulation,monitoring the speed,flow rate and pressure of ECMO,management of body temperature,skin care,sedation and pain,as well as prevention of complications.These nursing care measures would improve the survival rate after the treatment of ECMO.

ECMOcontinuous renal replacement therapysepsisfulminant myocarditischildrennursing

董瑞花、梁元卿、李娇、保兰花、李斌

展开 >

昆明市儿童医院儿科监护室,云南昆明,650200

体外膜肺氧合 连续性肾脏替代疗法 脓毒症 爆发性心肌炎 儿童 护理

云南省科技计划

201901C070447

2024

现代临床护理
中山大学

现代临床护理

CSTPCD
影响因子:1.317
ISSN:1671-8283
年,卷(期):2024.23(4)
  • 11