Neonatal Medicine

The Korean Society of Neonatology (대한신생아학회)
권호 표지

Two Cases of Neonatal Persistent Pulmonary Hypertension Treated by Veno-venous Extracorporeal Membrane Oxygenation (V-V ECMO)

정맥-정맥 도관 체외막형 산소섭취로 치료한 신생아의 지속성 폐동맥 고혈압증 2례

  • Yu, Hee-Joon (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Sung, Se-In (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Kim, Jin-Kyu (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Seo, Hyun-Joo (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Choi, Seo-Heui (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Yoo, Hye-Soo (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Ahn, So-Yoon (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Kim, Eun-Sun (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Yang, Ji-Hyuk (Department of Thoracic & Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Huh, June (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Chang, Yun-Sil (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Kang, I-Seok (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Jun, Tae-Kook (Department of Thoracic & Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Park, Won-Soon (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine)
  • 유희준 (성균관대학교 의과대학 삼성서울병원 소아과학교실) ;
  • 성세인 (성균관대학교 의과대학 삼성서울병원 소아과학교실) ;
  • 김진규 (성균관대학교 의과대학 삼성서울병원 소아과학교실) ;
  • 서현주 (성균관대학교 의과대학 삼성서울병원 소아과학교실) ;
  • 최서희 (성균관대학교 의과대학 삼성서울병원 소아과학교실) ;
  • 유혜수 (성균관대학교 의과대학 삼성서울병원 소아과학교실) ;
  • 안소윤 (성균관대학교 의과대학 삼성서울병원 소아과학교실) ;
  • 김은선 (성균관대학교 의과대학 삼성서울병원 소아과학교실) ;
  • 양지혁 (성균관대학교 의과대학 삼성서울병원 흉부외과학교실) ;
  • 허준 (성균관대학교 의과대학 삼성서울병원 소아과학교실) ;
  • 장윤실 (성균관대학교 의과대학 삼성서울병원 소아과학교실) ;
  • 강이석 (성균관대학교 의과대학 삼성서울병원 소아과학교실) ;
  • 전태국 (성균관대학교 의과대학 삼성서울병원 흉부외과학교실) ;
  • 박원순 (성균관대학교 의과대학 삼성서울병원 소아과학교실)
  • Published : 2010.05.31
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Abstract

Persistent pulmonary hypertension in newborns (PPHN) is a disorder of the vascular transition from fetal to neonatal circulation. It results in cyanosis due to right-to-left shunting of the blood through the ductus arteriosus and/or foramen ovale manifesting as hypoxemic respiratory failure. We managed two cases of PPHN after meconium aspiration with high frequency oscillating ventilators and inhaled nitric oxide. They did not respond to conventional management. Veno-venous extracorporeal membrane oxygenation (ECMO) was provided, and ECMO weaning was possible resulting survivals in two cases. We report two PPHN cases, which were treated successfully with veno-venous ECMO for the first time in Korea.

신생아의 지속성 폐동맥 고혈압증(PPHN)은 출생 후 폐동맥의 저항이 낮아지고 전신 혈관 저항이 올라가면서 폐로 가는 혈류가 증가하고 난원공과 동맥관을 통한 폐와 전신의 평행 순환에서 연속 순환인 신생아 순환으로 바뀌게 되는 과정에 문제가 있는 것이다. 저자들은 태변흡인이 있었던 두 명의 만삭아에서 고빈도 환기 요법과 흡인성 일산화질소 가스를 이용하여 PPHN을 치료하였으나 치료에 반응하지 않고 전신 장기에 산소화가 문제가되어 정맥-정맥도관체외막형산소섭취(V-V ECMO)를 시행하였고 두 증례 모두 체외막형 산소 섭취를 이탈하여 생존할 수 있었다. 현재까지 태변 흡인 증후군에 의해 생긴 PPHN 환아들에서 ECMO를 적용하여 치료한 국내 보고가 없고, 특히 V-V ECMO 적용으로 신생아를 치료한 보고 또한 없다. 이에 저자들은 태변 흡입 증후군에 의해 생긴 PPHN 환아들에서 V-V ECMO로 생존한 2례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

Keywords

References

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