在接受心脏手术的患者中,常规与最小侵入性体外循环:随机对照试验 (COMICS)
Gianni D Angelini1, Barnaby C Reeves1, Lucy A Culliford1
1Bristol Medical School, University of Bristol, Bristol, UK.
Perfusion
|June 4, 2024
概括
与传统方法相比,心脏手术后的严重不良事件 (SAE) 可能减少25%. 然而,由于疫情导致的早期试验终止引发了关于这些益处的不确定性.
科学领域:
- 心血管外科心血管外科
- 医疗技术 医疗技术 医学技术
- 患者安全 患者安全
背景情况:
- 心脏手术通常需要体外循环 (ECC).
- 最少侵入性体外循环 (MiECC) 旨在减少与常规ECC相关的并发症.
- 严重的不良事件 (SAE) 是心脏手术后的一个重大问题.
研究的目的:
- 评估MiECC是否与传统的体外循环 (CECC) 相比,降低心脏手术后SAE的风险.
- 评估二次结果,包括其他严重病例,死亡率,输血率和生活质量.
主要方法:
- 一个多中心,国际随机对照试验,比较MiECC和CECC.
- 包括18-84岁的患者,接受单独的CABG,AVR或联合CABG+AVR.
- 主要结局:30天内12次手术后的SAE组合;次要结局包括死亡率,输血和停留时间.
主要成果:
- 该试验随机选择了1071名患者 (535名为MiECC,536名为CECC) 在因COVID-19而提前终止之前.
- 在MiECC组中,9.7%的人经历了初级结果,而在CECC组中为13.2% (风险比率为0.732,p=0.025).
- 其他标榜企业也观察到类似的风险降低,尽管在统计学上并不显著.
结论:
- 在SAE的初级复合结果中,MiECC与统计学上显著的25%的相对风险降低有关.
- 试验的提前结束限制了关于MiECC的益处确定性的最终结论.
- 需要进一步的研究来证实MiECC在心脏手术中的安全性和有效性.
相关概念视频
Cardiac Catheterization I: Pre-Procedure Overview
Cardiac catheterization is an invasive diagnostic technique used to identify and evaluate structural and functional diseases of the heart and major blood vessels. This technique diagnoses congenital heart disease, coronary artery disease, valvular heart disease, and coronary spasms and assesses ventricular function. It helps guide treatment decisions, including the need for revascularization procedures like percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) and...
Cardiac Catheterization II: Right Heart Catheterization
Right Heart Catheterization: An OverviewRight heart catheterization is an invasive diagnostic procedure that measures right-sided cardiac and pulmonary artery pressures, calculates cardiac output, and identifies intracardiac shunts. It provides detailed hemodynamic data essential for diagnosing and managing various cardiovascular conditions, such as pulmonary hypertension.Access SitesCommon access sites for right heart catheterization include the internal jugular vein in the neck region, the...
Cardiac Catheterization III: Left Heart Catheterization
Left heart catheterization is an invasive diagnostic procedure used to evaluate the function and structure of the left side of the heart. It is generally performed to diagnose and treat cardiovascular conditions such as valve abnormalities, coronary artery disease, and congenital heart defects.Diagnostic and therapeutic purposesLeft heart catheterization serves various diagnostic and therapeutic purposes, including:Assessing coronary artery bypass grafts.Evaluating coronary artery disease in...


