在右心室衰竭中使用穿皮机械循环支持
Kartik Gupta1, Alejandro Lemor2, Ahmad Alkhatib3
1Division of Cardiovascular Diseases, Henry Ford Hospital, Detroit, Michigan, USA.
概括
右心室机械循环支持 (RV-MCS) 的使用正在增长. 在RV-MCS之前,高血清乳酸和中央静脉压 (CVP) 预测心力衰竭患者的住院死亡率.
科学领域:
- 心脏病学 心脏病学
- 心血管外科心血管外科
- 关键护理医学 关键护理医学
背景情况:
- 右心室衰竭的识别和RV-MCS设备的经验有限.
- 透皮RV-MCS为严重的RV功能障碍提供了潜在的解决方案.
研究的目的:
- 报告一个单一中心的经验,通过皮肤RV-MCS.
- 确定接受RV-MCS的患者不良结果的预测因素.
主要方法:
- 在接受RV-MCS的58名患者的单中心回顾性队列研究中.
- 收集有关并发症,血液动力学和实验室值的数据.
- 使用多变量逻辑回归分析医院内死亡率以排名预测因素.
主要成果:
- 48.3%的患者在住院期间死亡.
- 较高的RV-MCS前血清乳酸和CVP与增加的住院死亡率有关.
- 血清乳酸表明死亡率的最高预测值.
结论:
- 在这个现实世界队列中,接受RV-MCS治疗的52%的患者在指数住院后幸存下来.
- 目前的血清乳酸和CVP是住院死亡率的强有力的预测因素.
- 需要改善VR故障的识别和管理策略.
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