在毒性体外膜氧化期间的生存结果和动员:一项回顾性队列研究
Felix A Rottmann1, Christian Noe2, Xavier Bemtgen3
1Department of Medicine IV - Nephrology and Primary Care, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany.
Frontiers in medicine
|October 16, 2023
概括
在毒性体外膜氧化 (V-V ECMO) 上动员危急病患者显著改善了30天的生存率和呼吸机断奶率. 在V-V ECMO期间,患者的早期和渐进的流动性对于更好的结果至关重要.
科学领域:
- 临界护理医学 临界护理医学
- 支持心肺血管的支持.
- 患者康复 患者康复
背景情况:
- 毒性体外膜氧化 (V-V ECMO) 是严重肺衰竭的救生疗法.
- 在V-V ECMO期间的患者动员通常受到后勤和安全方面的限制.
- 早期动员对V-V ECMO患者结果的影响仍然是研究领域.
研究的目的:
- 调查V-V ECMO期间患者动员和30天生存率之间的关联.
- 评估V-V ECMO患者动员对机械通风和医院生存的影响.
主要方法:
- 一项回顾性队列研究包括343名接受V-V ECMO的患者 (不包括24小时以下支持的患者).
- 在V-V ECMO期间,患者根据ICU移动性评分 (≥2比<2) 进行了分层分类.
- 主要终点:30天生存率. 二级终点:ECMO断奶,机械通风断奶,以及医院生存率.
主要成果:
- 患有ICU流动性等级分数≥2的患者 (18%的队列) 显著改善了30天生存率 (71.0%与48.0%相比,或2.6).
- 更高的移动性得分与成功的呼吸机断奶相关 (61.3%与46.6%,或1.8).
- 强烈的动员,如站立,与更高的30天生存率 (OR 5.0) 有着强烈的相关性.
结论:
- 在V-V ECMO支持期间积极调动患者与改善30天生存率有显著的关联.
- 在V-V ECMO期间的动员也与机械通风成功断奶的更高率相关.
- 将早期和渐进的动员纳入V-V ECMO协议可以提高重症患者的康复和生存率.
相关概念视频
Peritoneal Dialysis II: Peritoneal Dialysis Systems and Complications
26
Peritoneal dialysis (PD) is a medical process that removes waste products and excess fluid from the body using the peritoneal membrane as a natural filter.Peritoneal Dialysis MethodsSeveral methods can be used for peritoneal dialysis, including Acute Intermittent Peritoneal Dialysis, Continuous Ambulatory Peritoneal Dialysis, and Automated Peritoneal Dialysis, also known as Continuous Cyclic Peritoneal Dialysis.Acute Intermittent Peritoneal Dialysis (AIPD) is used for patients with uremic...
26
Hemodialysis II: Procedure and Complications
27
DialyzersA hemodialysis (HD) dialyzer is a plastic cartridge containing thousands of parallel hollow fibers, which serve as semipermeable membranes. These fibers are typically made from cellulose-based or other synthetic materials. During HD, blood is pumped into the top of the cartridge and distributed among these fibers. Simultaneously, dialysis fluid, known as dialysate, is introduced into the bottom of the cartridge, bathing the outside of the fibers. Across the semipermeable membrane,...
27
Mechanical Ventilation II: Invasive Ventilation
173
Ventilators are essential medical equipment used to aid patients with respiratory difficulties. Their primary function is to assist or replace spontaneous breathing by providing mechanical ventilation. There are two general classes of mechanical ventilators: negative-pressure and positive-pressure ventilators.
Negative-Pressure Ventilators
Negative-pressure ventilators create a vacuum around the chest or body to draw air into the lungs, simulating breathing. This method does not require an...
Negative-Pressure Ventilators
Negative-pressure ventilators create a vacuum around the chest or body to draw air into the lungs, simulating breathing. This method does not require an...
173
Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
10
Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
10
Mechanical Ventilation III: Noninvasive Ventilation
146
Noninvasive positive-pressure ventilation (NIPPV), continuous positive airway pressure (CPAP), and bilevel positive airway pressure (BiPAP) are essential methods in respiratory care. These ventilation techniques offer unique benefits for patients with various respiratory conditions, providing adequate support without requiring intubation. Let's explore how each method is crucial in improving patient outcomes and enhancing respiratory therapy.
Noninvasive Positive-Pressure Ventilation...
Noninvasive Positive-Pressure Ventilation...
146


