在体外膜氧化过程中严重的肺功能障碍和肺血流
Lars Falk1,2, Marika Lidegran3, Sandra Diaz Ruiz3,4,5
1ECMO Centre Karolinska, ME Pediatric Perioperative Medicine and Intensive Care, Karolinska University Hospital, Akademiska Straket 14, 171 76 Stockholm, Sweden.
Journal of clinical medicine
|February 24, 2024
概括
心声学可以评估肺血流量,以预测体外膜氧化 (ECMO) 患者的康复. 计算机断层扫描 (CT) 在长期ECMO治疗败血症休克期间评估肺活力时无效.
科学领域:
- 关键护理医学 关键护理医学
- 心脏病学 心脏病学
- 肺部病理学 肺部病理学
背景情况:
- 身体外膜氧化 (ECMO) 是严重呼吸或循环衰竭的生命支持措施.
- 计算机断层扫描 (CT) 是ECMO期间肺损伤的标准成像.
- 评估肺活力和预测恢复仍然是长期ECMO中的挑战.
研究的目的:
- 为了确定心声回声学衍生的肺血流 (PBF) 是否可以在ECMO期间评估肺损伤.
- 调查心声回声,CT检测结果和患者结局之间的关联.
- 为了评估CT在ECMO期间可视化肺膜膜的有效性.
主要方法:
- 对患者 (>15年) 在ECMO治疗肺性败血性休克 (>28天) 的回顾性单中心研究.
- 查了277名患者,确定了9名连续CT和心声回声.
- 分析了PBF,CT发现,以及幸存者和非幸存者的结果.
主要成果:
- CT并没有区分幸存者和非幸存者之间可行的肺膜.
- 最初的PBF在幸存者和非幸存者中是相似的.
- 幸存者保持稳定的PBF,而非幸存者显示PBF显著恶化 (p=0.029).
- 不幸存者随着时间的推移,潮体积显著降低 (p=0.047).
结论:
- 对于评估肺活力或长期ECMO的复苏而言,CT是无效的.
- 通过心声学评估的PBF显示了在ECMO期间预测肺部恢复的潜力.
- 这项研究支持回声心脏学作为监测ECMO患者肺部状况的宝贵工具.
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