南非的体外膜氧化:来自私营部门单一中心的经验
N L F van Zijl1, J T Janson1, M Sussman2
1Division of Cardiothoracic Surgery, Department of Surgery, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
African journal of thoracic and critical care medicine
|January 19, 2024
概括
南非的体外膜氧化 (ECMO) 显示44%的生存率. 在转移的患者和转换ECMO类型的患者中观察到高死亡率,需要进一步调查和潜在的协议调整.
科学领域:
- 关键护理医学 关键护理医学
- 支持心肺血管的支持.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 身体外膜氧化 (ECMO) 是一种先进的,资源密集型疗法,在南非数据有限.
- 在南非背景下,关于ECMO利用和结果的数据很少.
研究的目的:
- 确定ECMO的适用情况.
- 评估早期患者的结果,包括存活到出院的情况.
- 识别并发症,并将结果与已建立的风险评分 (RESP和SAVE) 进行比较.
主要方法:
- 从2016年8月至2018年12月接受ECMO治疗的107名成年患者的回顾性审查.
- 操作和临床记录的分析.
- 观察到的生存率与呼吸ECMO生存预测 (RESP) 和静脉ECMO (SAVE) 后生存得分的比较.
主要成果:
- 医院出院后的总生存率为44.0% (47/107名患者).
- 主要指示是呼吸 (78名患者) 和心脏 (29名患者) 的支持.
- 单变量分析显示死亡率与性别,年龄和高血压之间的关联,在多变量分析中失去意义.
结论:
- 本研究提供了关于南非ECMO结果的第一份报告.
- 在ECMO转移的患者和从毒静脉转换为静脉动脉ECMO的患者中发现了高死亡率.
- 建议对SAVE和RESP得分进行外部验证,以改善南非人口的结果预测.
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