高风险ECMO患者的气管切除术:一种使用Rummel环护的床边混合扩张技术
Britton B Donato1,2, Marisa Sewell3, Megan Campany4
1Mayo Clinic, Department of Surgery, Phoenix, AZ, United States of America.
Surgery open science
|December 11, 2023
概括
使用鲁梅尔带的新型混合气管切口技术有效降低了体外膜氧化 (ECMO) 患者的出血风险. 这种安全有效的方法有助于在高风险的个体需要长期呼吸道的术后静血.
科学领域:
- 关键护理医学 关键护理医学
- 手术创新 在外科创新.
- 心肺支 提供心肺支
背景情况:
- 长时间的机械通风需要气管切除术,对于重症患者来说.
- 身体外膜氧化 (ECMO) 的使用量增加,导致更多的患者需要气管切除术,并有高出血风险.
- 由于出血风险,现有的气管切除术方法对ECMO患者构成挑战.
研究的目的:
- 引入和评估一种新的混合扩张气管切除技术.
- 评估鲁梅尔带在ECMO患者气管切开术期间减轻出血风险方面的有效性.
- 确定这种混合方法对外科手术期间静血的安全性和有效性.
主要方法:
- 采用了混合扩张气管切除术技术,其中包含了鲁梅尔带.
- 在2020年6月至2022年1月期间,ECMO治疗的24名患者接受了这种床边手术.
- 对患者进行了术后出血监测,特别注意术前和术后抗凝剂管理.
主要成果:
- 术后出血发生在16.67%的患者中 (24人中有4人).
- 血流并发症通过收紧鲁梅尔带和使用静血包装来保守地管理;不需要手术干预.
- 抗凝剂平均在手术前4.33小时和手术后5.2小时保持.
结论:
- 混合气管切除技术与鲁梅尔带是高风险ECMO患者术前静血的安全和有效补充.
- 这种技术成功地减轻了与气管切除术相关的出血并发症,在这个脆弱的人群中.
- 该方法最初是为COVID-19患者开发的,适用于所有需要气管切除术的ECMO患者,以减少出血风险.
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