感染的风险与长期的左心室辅助器件支持设备
Rajendra Karnatak1, Uriel Sandkovsky2
1Infectious Disease and Critical Care Medicine, Aurora Health, Milwaukee, USA.
Cureus
|August 7, 2023
概括
左心室辅助装置 (LVAD) 植入后的感染随着时间的推移而减少,挑战了免疫抑制理论. 然而,血流感染 (BSI) 增加了LVAD患者不良结果的风险.
科学领域:
- 心脏病学 心脏病学
- 免疫学 免疫学 免疫学
- 传染性疾病 传染性疾病
背景情况:
- 左心室辅助装置 (LVAD) 植入后的预期寿命有所改善.
- 有关可能损害细胞免疫力和增加感染风险的担忧存在,包括机会性感染,随着长期的LVAD支持.
研究的目的:
- 为了确定连续流 (C-F) LVAD植入后感染的发生率.
- 评估长期使用LVAD对感染率的影响.
- 评估血液感染 (BSI) 和不良结果 (如LVAD血栓,中风和死亡) 之间的关系.
主要方法:
- 在2013-2014年间接受C-F LVAD植入的患者的回顾性审查.
- 随访直到心脏移植,LVAD扩张,死亡或2017年底.
- 感染的分类 (VAD特定,VAD相关,非VAD) 和每1000个LVAD天的发病率计算.
主要成果:
- 感染的发病率显著下降,从第一年的3.2/1000天降至LVAD后第三年的0.78/1000天.
- 在同一时期,VAD特异性感染率也有所下降.
- 血流感染 (BSI) 没有增加死亡风险,但与较高的不良结果风险 (LVAD血栓,中风或死亡) 有关.
结论:
- 随着时间的推移,LVAD后感染率下降,这表明LVAD支持可能不会本质上导致免疫抑制.
- 血流感染是LVAD患者不良后果的重要危险因素.
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