儿科患者心脏切除术后体外膜氧化后的早期结果:当代的双国队列研究
Lachlan Crawford1,2, Supreet P Marathe2,3, Kim S Betts4
1Department of Cardiothoracic Surgery, Princess Alexandra Hospital, Brisbane, QLD, Australia.
概括
需要体外膜氧化 (ECMO) 的儿科心脏手术患者的死亡率和并发症率很高. 诺伍德程序与最高的ECMO发病率和死亡率有关.
科学领域:
- 心脏病学 心脏病学
- 儿科手术 儿科手术
- 关键护理医学 关键护理医学
背景情况:
- 身体外膜氧化 (ECMO) 是重症患者的生命支持措施.
- 心脏切除术后ECMO (PC-ECMO) 是用于心脏手术后的儿科患者.
- 这种人群中PC-ECMO的早期结果和风险因素需要进一步调查.
研究的目的:
- 评估需要PC-ECMO的儿科患者的早期结果.
- 确定与PC-ECMO使用和死亡率相关的风险因素.
- 评估这些患者并发症的发生率.
主要方法:
- 使用澳大利亚和新西兰先天性结果注册手术数据库进行了回顾性双国队列研究.
- 包括接受心脏手术并需要PC-ECMO (2013-2021) 的儿科患者 (<18岁).
- 分析了医院死亡率,主要并发症和相关风险因素.
主要成果:
- 在12,290名患者中,有376名患者 (3%) 需要PC-ECMO.
- 医院死亡率为35.6%,诺伍德手术患者的死亡率为48%.
- 三分之二的患者出现严重并发症;内出血和胸预测死亡率.
结论:
- 在需要PC-ECMO的儿科心脏手术患者中,很大一部分患者无法存活到出院.
- 诺伍德程序和经过修改的布拉洛克-塔斯西格分流器具有PC-ECMO的最高发病率.
- 严重并发症的高率强调了PC-ECMO在这个队列中的关键性质.
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