辐射暴露在体外生命支持中的辐射暴露
Sudhir Krishnan1, Edward Soltesz2, Justin Hanks1
1From the Respiratory Institute, Cleveland Clinic, Cleveland, Ohio.
ASAIO journal (American Society for Artificial Internal Organs : 1992)
|October 24, 2023
概括
身体外膜氧化 (ECMO) 患者通常会接受高剂量的辐射,超过国际辐射保护委员会 (ICRP) 的限制. 计算机断层扫描和干预性放射学对这种累积有效剂量 (CED) 有着显著的贡献.
科学领域:
- 放射学 放射学是一门学科.
- 医学物理 医学物理
- 关键护理医学 关键护理医学
背景情况:
- 身体外膜氧化 (ECMO) 需要经常进行放射性成像.
- 患者在ECMO期间的辐射暴露是一个越来越令人担忧的问题,可能会超过既定的安全限值.
研究的目的:
- 评估成年ECMO患者的电离辐射累积有效剂量 (CED).
- 将辐射暴露与国际辐射保护委员会 (ICRP) 的建议进行比较.
- 确定在ECMO和住院期间导致高辐射剂量的来源.
主要方法:
- 对306个成年ECMO入院的回顾性观察研究 (2016-2018).
- 基于放射学研究的参考值计算CED.
- 在ECMO和整个住院期间对辐射暴露的分析.
主要成果:
- 在ECMO期间,4.5%的患者超过了ICRP5年累积限值 (100mSv);14.7%在整个住院期间超过了它.
- 在ECMO期间的中位CED为2.3mSv,为17.4mSv的中位住院CED贡献13%.
- 计算机断层扫描 (CT) 和干预放射 (IR) 在ECMO期间占CED的88%以上,在住院期间占89%.
结论:
- 很大一部分ECMO患者接受了大量的辐射剂量,CT和IR是主要的贡献者.
- 目前的辐射暴露水平凸显了对ECMO患者修订指导方针和缓解策略的需要.
- 更长的住院时间与累计有效剂量增加相关,强调了整个患者住院期间辐射管理的重要性.
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