身体外膜氧化相关的隔间综合征:对国家数据库的审查
Harrison D Davis1, Theodore E Habarth-Morales2, Charles A Messa3
1Division of Plastic Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, Pennsylvania; Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania.
The Journal of surgical research
|April 9, 2024
概括
身体外膜氧化 (ECMO) 相关的隔间综合征 (CS) 是罕见的. 上肢CS (UE-CS) 患者比下肢CS (LE-CS) 患者有较少的断层切除和截肢,死亡率相似.
科学领域:
- 临界护理医学 临界护理医学
- 血管外科 血管外科
- 身体外生命支持器
背景情况:
- 分区综合征 (CS) 是一种罕见但严重的并发症,患者接受体外膜氧化 (ECMO).
- 关于ECMO相关的CS在上肢 (UE) 和下肢 (LE) 的流行病学和管理的数据有限.
研究的目的:
- 在ECMO患者中确定UE-CS与LE-CS相比UE-CS的流行病学.
- 描述UE-CS与LE-CS的治疗方法和结果.
主要方法:
- 分析了来自全国再接收数据库 (2015-2019) 的ECMO成年患者.
- 患者被分为UE-CS和LE-CS两组.
- 主要结局包括带切割和截肢率;死亡率和停留时间也使用风险调整模型进行评估.
主要成果:
- 在598个ECMO相关的CS病例中,84.8%在LE和15.5%在UE.
- 与LE-CS患者相比,UE-CS患者接受带切除 (50.5%vs70.9%) 和截肢 (3.3%vs23.7%) 的可能性明显低.
- 在UE-CS和LE-CS组之间,全因死亡率相似 (58.4%对65.4%).
结论:
- 与ECMO相关的CS与高死亡率和发病率有关.
- 与LE-CS相比,UE-CS与手术干预 (筋切割,截肢) 的比率较低,尽管死亡率相似.
- 需要进一步的研究,以了解这些观察到的管理和结果差异的根本原因.
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