外体膜酸素療法における緩和医療の利用:多センター観察研究
Bridget S Dillon1,2, William C Miller1,2,3, Olivia A Hood1,2
1University of Minnesota Medical School, Minneapolis, Minnesota, USA.
Journal of palliative medicine
|August 20, 2025
まとめ
静脈外膜酸素療法 (VV- ECMO) を受けている患者では,緩和ケア診療 (PCC) が一般的であった. しかし,統合されたPCCは,より高い診察率と関連しており,患者の結果に影響を及ぼしました.
科学分野:
- クリティカル ケア 医療
- 緩和ケア
- 医療サービス研究
背景:
- 緩和医療は重篤な病気の患者を治療するものです
- 外体膜酸素化 (ECMO) は ~50%の死亡率で重度の心臓/呼吸器不全を治療します.
- ECMO患者における緩和治療の役割は十分に研究されていない.
研究 の 目的:
- 毒性ECMO (VV-ECMO) 患者における緩和ケア相談 (PCC) の特徴を明らかにする.
- この集団におけるPCCに関連した要因を特定する.
主な方法:
- ミネソタ州のECMOセンターの4つのコホート研究.
- 患者の人口統計,ECMOの特徴,PCCのデータを収集した.
- 統合されたPCCプロトコルとPCCプロトコルのないセンター間のPCC率と結果の比較
主要な成果:
- 420人のVV- ECMO患者の54. 8%がPCCを受けた.
- PCCの投与は出院までの生存率の低下と関連していた (52. 6% vs 72. 6%,p< 0. 001).
- EHRの注文セットに自動PCCを搭載したセンターは,PCCを搭載していないセンターと比較して,PCC率 (81.6%と49.4%) が著しく高かった.
結論:
- 大多数のVV- ECMO患者はPCCを受けた.
- 統合されたPCCは,相談率を大幅に増加させました.
- VV- ECMO患者のアウトカムに対するPCCの影響を理解するためにさらなる研究が必要です.
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