身体外膜氧化桥梁到儿科肺移植:现代时代的分析分析
Wonshill Koh1,2, Huaiyu Zang1, Nicholas J Ollberding2,3
1Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
Pediatric transplantation
|July 10, 2023
概括
在儿科肺移植 (LTx) 时的体外膜氧化 (ECMO) 支持不会影响生存结果. 这项研究发现,接受ECMO治疗的儿童与未接受ECMO治疗的儿童在移植后的存活率没有显著差异.
科学领域:
- 儿科重症监护医药 儿科重症监护医药
- 支持心肺血管的支持.
- 器官移植 器官移植 器官移植
背景情况:
- 儿童肺移植 (LTx) 接受者在移植时需要体外膜氧化 (ECMO) 支持的生存结果尚未得到充分确立.
- 了解ECMO对LTx结果的影响对于优化患者护理至关重要.
研究的目的:
- 为了比较儿科LTx接受者的移植后存活率,根据肺移植时体外膜氧化 (ECMO) 支持的存在或不存在.
- 确定ECMO支持是否影响该患者群体的生存结果.
主要方法:
- 在2000年1月至2020年12月期间,使用联合器官共享注册网络对儿科首次LTx接受者进行了回顾性分析.
- 使用单变量分析,多变量考克斯回归和倾向性得分匹配来比较ECMO支持和没有ECMO支持的患者之间的存活率.
- 该研究包括954名儿科LTx接受者,其中40名患者在移植时得到ECMO的支持.
主要成果:
- 在接受ECMO和未接受ECMO的儿科患者之间,没有观察到在LTx后生存的显著差异.
- 多变量考克斯回归分析没有显示在ECMO治疗的患者中,LTx后死亡风险增加 (危险比率=0.83;95%CI:0.47,1.45;p=0.51).
- 倾向性得分匹配 (33名ECMO与33名非ECMO患者) 进一步证实,两组之间没有生存差异 (危险比率=0.98;95% CI:0.48,2.00;p=0.96).
结论:
- 在当代的一组儿科肺移植接受者中,在LTx时使用体外膜氧化 (ECMO) 并没有对移植后生存产生负面影响.
- 这些发现表明,ECMO可以安全地用于儿科肺移植,而不会影响长期生存结果.
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