在体外膜氧化支持后,管相关动脉血栓形成的危险因素:一项回顾性研究
Ngan Hoang Kim Trieu1,2, Xuan Thi Phan3, Linh Thanh Tran2
1Department of Emergency and Critical Care Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam.
Acute and critical care
|August 31, 2023
概括
管相关动脉血栓形成 (CaAT) 影响超过60%的患者在静脉外体膜氧化 (VA-ECMO) 后. 较高的ECMO流速-体表面积比率是CaAT的关键风险因素.
科学领域:
- 心血管医学 心血管医学
- 关键护理医学 关键护理医学
- 生物医学工程 生物医学工程
背景情况:
- 身体外膜氧化 (ECMO) 可能会由于血液循环相互作用和剪切应激导致静血功能障碍.
- 这种相互作用加速了凝血级联,导致ECMO系统和血管内形成血栓.
- 管相关动脉血栓形成 (CaAT) 是ECMO治疗后的一个显著并发症.
研究的目的:
- 为了确定从静脉ECMO (VA-ECMO) 或混合模式脱管后CaAT的发生率.
- 确定与CaAT.发展相关的独立风险因素.
- 评估CaAT患者的临床特征和结果.
主要方法:
- 在ECMO后接受动脉管切除的患者进行了一项回顾性研究.
- 收集的数据包括患者特征,ECMO参数,管大小,血液产品输血和每日静血标记.
- 采用多变量分析来确定CaAT的独立风险因素.
主要成果:
- 该研究包括47名需要VA-ECMO或混合支持的患者.
- 在61.7%的患者中观察到CaAT,表面大腿动脉血栓是最常见的部位 (51.7%).
- 确定ECMO流速与体表面积 (BSA) 的比率是CaAT的独立风险因素 (OR 0.79,P=0.014).
- 肢体缺血并发症发生在17.2%的CaAT患者中.
结论:
- 在VA-ECMO或混合支持后,CaAT的发病率很高 (61.7%).
- ECMO流速-BSA比率是CaAT的一个重要的独立风险因素.
- 建议在VA-ECMO后对动脉血栓的查,需要对其益处进行进一步的研究.
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