用吸入NO治疗的VVECMO治疗严重ARDS患者的分析:一项回顾性观察性研究
Stefan Muenster1, Jennifer Nadal2, Jens-Christian Schewe1,3
1Department of Anesthesiology and Intensive Care Medicine, University Hospital Bonn, 53127 Bonn, Germany.
Journal of clinical medicine
|March 28, 2024
概括
在接受静脉静脉外体膜氧化 (VV-ECMO) 的严重急性呼吸困扰综合征 (ARDS) 患者中,吸入的氧化 (NO) 并没有改善结果,并且与死亡率增加有关.
科学领域:
- 临界护理医学 临界护理医学
- 支持心肺血管的支持.
背景情况:
- 对需要VV-ECMO的严重ARDS患者的回顾性分析.
- 研究了吸入NO用于肺动脉高血压 (PAH) 和/或右心室 (RV) 衰竭的使用.
研究的目的:
- 评估吸入NO在严重ARDS患者的疗效和对VV-ECMO的影响.
- 评估了NO对PAH,RV衰竭和患者结局的影响.
主要方法:
- 48名接受吸入NO的患者与没有吸入NO的患者的结局进行了比较.
- 分析了NO的指示,剂量,持续时间和对PAH的影响.
- 评估机械通风持续时间,ECMO断奶,器官功能障碍和死亡率.
主要成果:
- 只有三分之一的患者表现出吸入NO的肺动脉压下降.
- NO组经历了更长的VV-ECMO持续时间,更高的断奶失败率,以及增加的死亡率.
- 吸入NO与VV-ECMO治疗ARDS患者死亡风险增加两倍有关.
结论:
- 在接受VV-ECMO治疗的严重ARDS患者中,持久的PAH和/或VR衰竭与糟糕的结果相关.
- 吸入NO的反应率很低 (30%),并没有改善存活率或减少急性功能衰竭.
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