在COVID-19患者的Cannula相关深静脉血栓中,VV ECMO支持的VV ECMO患者
Erin Niles1, Mary Maldarelli2, Joseph Hamera3,4
1Critical Care Resuscitation Unit, R Adams Cowley Shock Trauma Center, Baltimore, MD, USA.
The journal of vascular access
|January 3, 2024
概括
毒性ECMO患者,无论是COVID-19还是非COVID-19,都有很高的管相关深静脉血栓症 (CaDVT). 在COVID-19患者治疗后,持续性CaDVT的发病率较高.
科学领域:
- 心脏病学 心脏病学
- 肺部病理学 肺部病理学
- 关键护理医学 关键护理医学
背景情况:
- 毒性体外膜氧化 (VV ECMO) 是严重呼吸衰竭的重要救援疗法.
- 管相关的深静脉血栓塞 (CaDVT) 是VV ECMO的一个已知的并发症.
- 超过14000名COVID-19患者已经接受了呼吸衰竭的VV ECMO.
研究的目的:
- 为了比较COVID-19患者中CaDVT的发生率与接受VV ECMO的非COVID-19患者.
- 为了调查COVID-19的高凝血状态是否会在VV ECMO期间增加CaDVT风险.
主要方法:
- 在2014-2022年期间,对291名成年患者进行了VV ECMO的回顾性观察性研究.
- 主要结局:CaDVT发生率在脱后24小时内.
- 二次结局:在后续成像时持续的CaDVT.
主要成果:
- 在COVID-19 (95%) 和非COVID-19 (88%) 组中都有高的CaDVT发病率,没有显著差异 (p=0.13).
- 在重复成像时,COVID-19患者的持续性CaDVT发生率显著更高 (78%对56%,p=0.03).
结论:
- 推对所有VV ECMO患者进行CaDVT的例行查.
- 重复静脉双重超声波对于评估持续的CaDVT和指导治疗在两个人群中至关重要.
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