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科学领域:

  • 心血管科学 心血管科学
  • 关键护理医学 关键护理医学
  • 呼吸系统医学 呼吸系统医学

背景情况:

  • 体外膜氧化 (ECMO) 是一种用于重症监护的生命支持技术.
  • 低容量中心在维护ECMO专业知识和实现最佳结果方面面临挑战.
  • 将结果与既定分数进行比较对于质量评估至关重要.

研究的目的:

  • 评估两个澳大利亚三级医院的ECMO经验.
  • 使用验证的评分系统,将观察到的患者死亡率与预测的死亡率进行比较.
  • 评估ECMO在呼吸衰竭,心力衰竭和体外心肺复苏 (eCPR) 患者群体中的性能.

主要方法:

  • 采用了病例系列设计,分析了使用ECMO治疗的成年患者 (>18岁) 的数据.
  • 患者被分为呼吸衰竭,心力衰竭和eCPR队列.
  • 观察到的死亡率与呼吸ECMO生存预测 (RESP) 评分,静脉ECMO (SAVE) 评分后的存活率,修改后的SAVE评分和体外生命支持组织 (ELSO) 登记册对eCPR的基准预测进行了比较.

主要成果:

  • 在10年的时间里,86名患者接受了ECMO. 呼吸衰竭组 (49名患者) 有8例死亡,明显低于RESP得分预测的 (P < 0.001).
  • 心力衰竭组 (27名患者) 有9例死亡,低于标准SAVE得分预测 (P < 0.001),但与修改后的SAVE得分一致 (P > 0.05).
  • 电子CPR组 (10名患者) 有7例死亡,与ELSO注册预测一致.

结论:

  • 在这两个低体积的ECMO中心的死亡率并不低于既定基准.
  • 这些发现表明,即使在较小的字母体积的中心,也可以提供有效的ECMO护理.
  • 这项研究为澳大利亚环境中的ECMO结果和表现提供了有价值的见解.