由于COVID-19而导致急性呼吸衰竭的体外膜氧化:一个多中心匹配的队列研究
Sage P Whitmore1, Katherine J Cyr2, Elliott S Cohen1
1From the Department of Critical Care Medicine, TriStar Centennial Medical Center, Nashville, Tennessee.
概括
静脉静脉外体膜氧化 (ECMO) 显著降低了COVID-19严重呼吸衰竭的医院死亡率. 此外,ECMO还改善了患者的治疗结果,包括从机械通风和有利的排放目的地中解放出来.
科学领域:
- 关键护理医学 关键护理医学
- 支持心肺血管的支持.
- 传染性疾病 传染性疾病
背景情况:
- 机械通风用于COVID-19相关的呼吸衰竭带来高死亡率.
- 静脉静脉外体膜氧化 (ECMO) 为严重病例提供了一个潜在的替代方案.
研究的目的:
- 评估ECMO对COVID-19患者住院死亡率和出院状态的影响.
- 为了比较ECMO和常规机械通风治疗严重低血的结果.
主要方法:
- 追溯性多中心研究模拟实用性试验.
- 粗制精确匹配用于比较278名ECMO患者和2,054名非ECMO患者.
- 主要结局:调整后的住院死亡率;次要结局:呼吸机/ICU日,出院目的地.
主要成果:
- 调整后的住院死亡率在ECMO组 (38.8%) 与对照组 (60.1%) 相比显著较低.
- ECMO与机械通风释放率的增加有关.
- 在ECMO患者中,重症监护室出院率更高,出院目的地更有利.
结论:
- 对于经过精心挑选的严重呼吸衰竭的COVID-19患者,ECMO与改善的生存率和更好的出院结果有关.
- 这些发现支持ECMO在管理COVID-19严重呼吸道疾病方面的明智使用.
相关概念视频
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