设施间VV-体外膜氧化转移的结果:一个多中心研究
Conner Olson1, Jillian Wothe1,2,3,4, Jacob Braaten1
1From the University of Minnesota Medical School Department of Surgery, Minneapolis, USA.
概括
对于体外膜氧化 (ECMO) 的设施间传输是安全的. 这项研究发现,转移到ECMO中心的患者并没有增加并发症或死亡率,这支持了当前的做法.
科学领域:
- 心血管医学 心血管医学
- 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:
- 身体外膜氧化 (ECMO) 的可用性正在增加,导致更多的设施间转移.
- 将ECMO患者转移到专科中心的影响尚不清楚.
- 之前的研究还没有充分评估设施间ECMO转移的安全性和结果.
研究的目的:
- 调查医院间转移与患者结果 (包括并发症和死亡率) 之间的关联.
- 为了比较ECMO中心管治疗的患者与从外医院转移的患者的结果.
- 评估运输方式 (空中与地面) 在ECMO转移期间对患者结果的影响.
主要方法:
- 在全州注册处接受毒性 (VV) ECMO的成年患者的回顾性队列研究.
- 并发症,死亡率,ECMO持续时间,停留时间和处置情况的比较.
- 风险调整后的物流回归分析,根据管部位和运输方法对结果进行比较.
主要成果:
- 该研究包括420名成年患者,其中36%的患者在转移前在ECMO中心外进行了管治疗.
- 在转移的患者中,63%是通过地面运输到达,其余是通过航空运输到达.
- 经风险调整的分析显示,ECMO中心管治疗的患者与从转诊医院转移的患者的死亡率相似 (OR = 0.77,CI = 0.49-1.22).
结论:
- 在ECMO患者的设施间转移与死亡率的增加无关.
- 这些发现支持将患者转移到专门的ECMO中心的持续做法.
- 目前的转移协议似乎是安全的,不会对患者的生存结果产生负面影响.
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