在静脉外体膜氧化患者中,死亡率和输血需求的预测因素
Jongmin Kim1, Hye Ju Yeo2,3, Woo Hyun Cho2,3
1Department of Laboratory Medicine, Pusan National University Hospital, Busan, Korea.
Laboratory medicine
|September 14, 2023
概括
严重的血小板缺血预测静脉外体膜氧化 (ECMO) 患者的死亡率. 血小板输血的数量没有影响存活率,但已经确定了输血需求的预测因素.
科学领域:
- 心脏病学 心脏病学
- 临界护理医学 临界护理医学
- 血液学 血液学 血液学
背景情况:
- 静脉外体膜氧化 (ECMO) 是严重的循环衰竭的生命支持措施.
- 预测ECMO患者的结果对于资源配置和治疗策略至关重要.
- 血小板缩和血小板输血在ECMO存活率中的作用仍然不完全理解.
研究的目的:
- 确定血小板缩和血小板输血量对静脉动脉ECMO接受者的生存期的预后意义.
- 为了确定预测在静脉动脉ECMO支持期间需要增加血小板输血的因素.
主要方法:
- 在2008年12月至2020年3月期间,对218名接受静脉动脉ECMO治疗的患者进行了回顾性分析.
- 单变量和多变量考克斯回归分析用于医院死亡率预测.
- 逐步多重线性回归以确定输血需求的预测因素.
主要成果:
- 严重的血小板缺血是住院死亡率的独立预测因素 (HR = 2.840,P < .001),与年龄,ECMO前心脏骤停和pH一起.
- 进行的血小板输血量与住院死亡率无关.
- 一些变量,包括ECMO指示类型,与增加的输血需求有关.
结论:
- 严重的血小板缺血是静脉ECMO患者住院死亡率的重要独立预后因素.
- 血小板输血量似乎不会影响这一队列的生存结果.
- 确定了ECMO期间血小板输血需求升高的预测因素,有助于临床管理.
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