新生児および小児における体外膜酸素化におけるエクストゥベーションに関する大規模な単一センターの経験
Caroline Holton1, Johanna Orrick2, Debra Newton2
1From the Division of Critical Care, Department of Pediatrics, University of Missouri-Kansas City and Children's Mercy Hospital, Kansas City, Missouri.
まとめ
選択された小児の患者を体外膜酸素化 (ECMO) で抽出することは実行可能で安全です. このアプローチは肺損傷を軽減し,患者のアウトカムを改善し,エクスタブされた患者の生存率が高くなります.
科学分野:
- 小児重症治療薬
- 心肺のサポート
- 新生児の集中治療
背景:
- 新生児および小児の新生児および小児の新生児および小児の新生児および小児の新生児および小児の新生児および小児の新生児および小児の新生児および小児の新生児および小児の新生児および小児の新生児および小児の新生児および小児の新生児および小児の新生児および小児の新生児および小児の新生児および小児の新生児および小児の新生児および小児の新生児および小児の新生児および小児の新生児および小児の新生児および小児の新生児および小児の新生児.
- 小児の集団でECMOを施している間,エクストゥベーションの実行可能性と安全性に関するデータは限られている.
研究 の 目的:
- 単一センターでのECMO患者のエクスタブ体験について説明します.
- このコホートにおけるエクストゥベーションに関連した結果と合併症を評価する.
主な方法:
- 2013年から2022年までのECMOを受けた患者の遡及コホート研究.
- 心臓病科,小児科,新生児重症病棟におけるエクスタブされた対非エクスタブされたECMO患者の分析.
- 生存率と合併症プロフィールの比較
主要な成果:
- 40人の患者 (ECMOの8. 6%) がECMOでエクスチューブされ,最大規模の単一センター小児科コホートであった.
- エクスチューブされた患者は高齢で,肺のサポートを受け,ECMOの走行期間が長かった.
- 出院までの生存率は,エクスタブされた患者の75%で,エクスタブされていないグループより有意に高かった (p=0. 044).
- 調整した分析では,胃腸出血と継続的な腎置換療法 (CRRT) の使用が増加したが,他の主要な合併症は増加しなかった.
結論:
- 選択された小児患者の場合,ECMOによる抽出は実行可能で安全な戦略です.
- この慣行は,退院までの生存率の改善と関連しています.
- 胃腸出血やCRRTの使用などの合併症はより頻繁に発生したが,全体的に重大な合併症は増加しなかった.
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