在接受体外膜氧化疗法的患者中,持续的置换疗法
Meera Raja1, Ricardo Leal1, James Doyle1
1Department of Adult Intensive Care Unit, Brompton Hospital, London, UK.
Journal of the Intensive Care Society
|June 1, 2023
概括
集成到体外膜氧化 (ECMO) 电路中的连续脏替代疗法 (CRRT),称为eCRRT,与标准CRRT (vCRRT) 相比,在ECMO患者中提供了更好的过器寿命和疗效.
科学领域:
- 密集护理医学 密集护理医学
- 腎臟病學 (nephrology) 是一種醫學專業.
- 支持心肺血管的支持.
背景情况:
- 连续置换疗法 (CRRT) 对于管理严重病患者的液体和电解质平衡至关重要.
- 体外膜氧化 (ECMO) 用于严重的呼吸或心力衰竭,通常需要同时进行CRRT.
- 有不同的方法可以将CRRT与ECMO集成在一起,每个方法都有潜在的好处和风险.
研究的目的:
- 在ECMO患者中比较两种CRRT方法的疗效和安全性:与ECMO电路 (eCRRT) 进行串联使用,与使用专用中央静脉管 (vCRRT) 相比.
- 为了评估eCRRT和vCRRT之间的过器寿命和治疗有效性.
主要方法:
- 对20名接受ECMO和CRRT治疗的患者进行了比较评估.
- 根据CRRT整合方法,患者被分为两组:eCRRT (与ECMO电路连续使用) 和vCRRT (专用中央静脉管).
- 测量的主要结果包括过器寿命和不良事件的发生率.
主要成果:
- 与vCRRT组 (28小时) 相比,eCRRT组的平均过器寿命 (42小时) 显著更长.
- 更高的百分比的eCRRT过器运行完成了目标72小时 (40%) 与vCRRT (13.8%) 相比.
- 在vCRRT组中发生了一例ECMO电路空气栓塞,突出了潜在的安全问题.
结论:
- eCRRT提供了足够的脏替代疗法,并提高了ECMO患者的过器寿命.
- 电子CRRT是一种安全有效的方法,当预先存在的透析中央静脉小管无法使用时,它成为首选的方法.
- 将CRRT直接集成到ECMO电路中,在需要两种疗法的重症患者的管理中具有优势.
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