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心脏切除术后体外生命支持的临床实践中的异质性:来自PELS-1多中心研究的试点调查

Silvia Mariani¹, Gabor Bari², Justine M Ravaux¹

¹Cardio-Thoracic Surgery Department, and Cardiovascular Research Institute Maastricht, Maastricht, The Netherlands.

Artificial organs

|June 23, 2023

概括

心脏切割术后体外生命支持 (PC-ECLS) 的实践在各医院之间有很大差异. 需要标准化的协议来改善患者护理和PC-ECLS管理的结果.

科学领域:

心血管外科心血管外科
临界护理医学临界护理医学
身体外生命支持器

背景情况:

对心脏切除术后体外生命支持 (PC-ECLS) 管理的高质量证据有限.
这项研究旨在调查PC-ECLS的现实临床实践.

研究的目的:

探索PC-ECLS的中心组织和管理策略的变化.
确定PC-ECLS临床实践中异质性的关键领域.

主要方法:

进行了一项跨部门,多机构的国际试点调查.
34家医院参与,回答了关于PC-ECLS实践的29个问题.
调查涵盖了抗凝,卸载, perfusion,监测和输血协议.

主要成果:

在抗凝药 (75%使用出血状态,54.2%没有值) 和输血目标 (7-10 g/dL) 中观察到显著的异质性.
大多数中心使用心脏通风 (78.1%) 和远端输液 (84.4%) 在个案或定期基础上.
54.9%的中心报告了专门的监测协议,使用心声学,Swan-Ganz,NIRS和四肢缺血评估.

结论:

在心脏切除术后的体外生命支持当前的临床实践中存在着显著的异质性.
建议对PC-ECLS进行协议的标准化和改进基于证据的指导方针的实施.

关键词:

心脏外科手术是一项心脏手术.临床实践中的临床实践身体外生命支持生命支持这是心脏衰竭.心脏切除术后的休克冲击.调查调查调查调查

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