在体外心肺复苏期间使用上腺素剂量:单中心回顾性队列
Nicholas M Kucher1, Alexandra M Marquez1, Anne-Marie Guerguerian1
1Department of Critical Care Medicine, University of Toronto, The Hospital for Sick Children, Toronto, ON, Canada.
概括
在儿科心脏骤停期间使用上腺素的剂量在需要体外膜氧化 (ECMO) 的患者中没有显著增加后负载. 需要进一步的研究来证实这些关于ECMO支持和患者结果的发现.
科学领域:
- 儿科重症监护医学 儿科重症监护医学
- 心血管研究研究心血管研究
- 身体外生命支持器
背景情况:
- 儿科心脏骤停指南建议使用上腺素.
- 上腺素对体外膜氧化 (ECMO) 患者的全身后负荷的影响尚不清楚.
研究的目的:
- 调查在复苏期间接受ECMO的儿科患者内上腺素剂量和全身后负荷之间的关联.
- 评估上腺素对ECMO支持参数的影响.
主要方法:
- 对儿科患者 (0-18岁) 的回顾性观察性研究,需要在复苏期间使用ECMO.
- 从最后一次上腺素剂量到ECMO启动,累计剂量和停止时间的分析时间.
- 通过平均动脉压和血管扩展剂的使用来评估系统后负荷;通过流量和血管活性-内热量评分 (VIS) 来支持ECMO.
主要成果:
- 总共分析了87名患者的69个事件.
- 在最后一次上腺素剂量和ECMO启动之间的中位数间隔为6分钟.
- 较短的上腺素-ECMO间隔与血管扩展剂的使用增加相关 (p=0.05),但与平均动脉压 (p=0.06) 或其他ECMO支持措施无显著相关.
结论:
- 有限的证据表明,心脏骤停期间的上腺素剂量与ECMO管后负载增加无关.
- 需要进一步的研究来验证这些发现并评估临床结果.
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