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左心室補助装置のサポート中の感染症は,移植後の結果に影響しません
P Sinha1, J M Chen, M Flannery
1Columbia University College of Physicians and Surgeons, Columbia Presbyterian Medical Center, New York, NY 10032, USA.
Circulation
|November 18, 2000
まとめ
Ventricular Assist Device (VAD) サポートは感染リスクを増加させる可能性がありますが,効果的な管理プロトコルは,VAD患者が非VAD患者と比較して同様の移植生存率を持っていることを意味します.
科学分野:
- 心臓病学 心臓病学
- 感染症 感染症とは
- 移植 移植 移植
背景:
- 心室補助器具 (VAD) サポート中の感染症は,移植生存率に影響を与える可能性があります.
- VAD関連感染症の移植後の影響については,さらなる調査が必要である.
研究 の 目的:
- 外来治療プログラム,新しいVADデバイス,更新された感染管理が移植後のアウトカムに与える影響を評価する.
- VAD患者における感染関連のリスクと生存率を,VADでない対照群と比較して評価する.
主な方法:
- 86人のVAD患者と50人のマッチングした非VAD対照患者の遡及的分析.
- 周周移植と移植後の感染率と,それぞれ6ヶ月と3年の精算的生存率の比較.
- 臨床的徴候と積極的な培養によって定義される感染であり,介入が必要である.
主要な成果:
- VADのサポート中に高い感染発生率は,移植前のまたは移植後の死亡率や全生存期に影響しませんでした.
- LVADを受けた患者は,対照群 (P<0.05) と比較すると,感染の発生率が低いことを経験しました.
- 3年生存率は,LVAD受容者の79%,対照群の87%で,ほぼ同じでした.
結論:
- VADは早期の移植後の感染リスクを高めますが,移植可能性や患者の生存に悪影響を及ぼしません.
- 病院内および病院外での感染制御の効果的な戦略は,有害な結果を軽減する可能性が高い.
- 現代のVADのサポートと管理プロトコルは,移植後の長期的な生存に寄与します.
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