Pediyatrik EKMO

Op. Dr. Murat UĞURLUCAN,
Özel Anadolu Sağlık Merkezi Hastanesi, Kalp ve Damar Cerrahisi Kliniği
Prof. Dr. Sertaç ÇİÇEK
Özel Anadolu Sağlık Merkezi Hastanesi, Kalp ve Damar Cerrahisi Kliniği

Özet

Erişkin hastalarda EKMO ile uygulanan tedaviler ilk başlarda yüz güldürücü olama-masına rağmen aynı dönemde solunum yetmezliği nedeniyle pediyatrik vakalardaki uygulamalar son derece başarılı olmuştur. Sağlık ve teknoloji alanındaki gelişmelerle beraber günümüzde EKMO, hayat kurtarıcı rolünün yanı sıra, tedavi edici ve önleyici görevlerde de sıklıkla kullanılabilmektedir. Yenidoğan ve pediyatrik yaş grubu, erişkin-den farklı olarak kendine özgü anatomik, fizyolojik, metabolik, immunolojik, inflamat-uar mekanizmalara sahiptir. Bu nedenle erişkin ve pediyatrik hastalar arasındaki fizyopatolojik mekanizmalar iyi bilinmeli, EKMO uygulanmak istendiğinde parame-treler pediyatrik grubun özelliklerine göre ayarlanmalıdır. Tüm bunların ötesinde EKMO’nun hasta için faydası ve beklentiler göz önünde bulundurulmalıdır. İlerleyen teknoloji, anestezi ve cerrahi tekniklere rağmen EKMO halen mortalitesi yüksek olabilmektedir. Hastane maliyetlerini de önemli ölçüde arttırmaktadır. EKMO her ne kadar uygun vakalarda kullanıldığında hayat kurtarıcı olsa da kardiyopulmoner yetmezliği olan her hasta için endikasyon tartışmalıdır ve birçok komplikasyonu beraberinde getirebilir. Hastadaki patoloji iyi değerlendirilmeli, alternatif tedavi yöntemleri gözden geçirilmeli, gerekiyorsa uygulanmalı ve son çare olarak kardiyopul-moner fonksiyonları yeniden geri dönebilecek en uygun hastalara uygulanmalıdır.

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