肺栓塞的体外膜氧化:系统性审查和元分析
Jonathan Jia En Boey1,2, Ujwal Dhundi3, Ryan Ruiyang Ling4
1Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia.
Journal of clinical medicine
|January 11, 2024
概括
体外膜氧化 (ECMO) 可以改善高风险肺栓塞 (HRPE) 患者的生存率. 与ECMO一起的导导管治疗显示出比系统性血栓溶解更低的死亡率.
科学领域:
- 心脏病学 心脏病学
- 临界护理医学 临界护理医学
- 肺部医学 肺部医学
背景情况:
- 体外膜氧化 (ECMO) 用于高风险的肺栓塞 (HRPE) 与血液动力学不稳定.
- 目前的指导方针将ECMO限制在心脏骤停或循环衰竭病例中,并使用治愈疗法.
- 本研究评估了ECMO在HRPE中的死亡影响,并比较了辅助疗法.
研究的目的:
- 用ECMO治疗的HRPE成年人死亡率的特征.
- 为了确定与这些患者的死亡率相关的因素.
- 为了比较使用ECMO的不同治疗疗法的有效性.
主要方法:
- 39项观察性研究 (6409名患者) 的系统综述和元分析.
- 搜索了四个国际数据库,直到2023年6月25日.
- 评估住院死亡率,偏见风险和证据的确定性.
主要成果:
- 在ECMO治疗中,HRPE患者的综合死亡率为42.8%.
- 导管治疗的ECMO的死亡率 (28.6%) 比系统性血栓溶解 (57.0%) 低.
- 在ECMO前的心脏骤停和心率显著影响死亡率.
结论:
- 在接受ECMO治疗的HRPE患者中,超过50%的患者存活下来.
- 早期ECMO是HRPE的一个有价值的稳定措施.
- 与其他治疗疗法相比,使用ECMO的全身血栓溶解与较高的死亡率有关.
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