胚胎液栓塞中的体外膜氧化:对病例报告的系统审查
Ngan Hoang Kim Trieu1, Nam Nhat Nguyen2, Huy Minh Pham1
1From the Department of Critical Care Medicine, Cho Ray Hospital, Ho Chi Minh City, Vietnam.
概括
体外膜氧化 (ECMO) 是安全有效的治疗羊水栓塞 (AFE),严重的产科并发症. 早期ECMO干预可以提高AFE患者的生存率,特别是那些患有循环衰竭的患者.
科学领域:
- 产科和妇科 产科和妇科
- 关键护理医学 关键护理医学
- 心血管研究研究心血管研究
背景情况:
- 胎液栓塞 (AFE) 是一种罕见但灾难性的产科紧急情况.
- 急性循环衰竭是AFE的标志,通常导致高孕产妇死亡率.
- 体外膜氧化 (ECMO) 在管理AFE,特别是凝血病的作用仍然不清楚.
研究的目的:
- 系统地审查和评估ECMO支持在被诊断为羊水栓塞的患者的疗效和安全性.
- 评估使用ECMO治疗的AFE患者的孕产妇存活率和神经结果.
主要方法:
- 对病例报告进行了系统审查,遵守PRISMA指南.
- 分析了33项涉及79名AFE患者的研究的数据.
- 包括的研究的质量评估是使用标准化工具进行的.
主要成果:
- 大多数AFE病例发生在剖腹产 (55.2%) 或分娩 (26.7%) 期间.
- 静脉ECMO是主要使用的配置 (81.3%).
- 孕产妇的存活率为72%,其中21.2%经历轻微和5.8%主要的神经后果.
结论:
- 救援ECMO在支持羊水栓塞患者的血液循环方面展示了安全性和有效性.
- 建议在AFE诊断时提前激活ECMO.
- 需要进一步的研究,以充分阐明早期ECMO实施在AFE管理中的好处.
相关概念视频
Pulmonary Embolism I: Introduction
1.5K
Pulmonary embolism (PE) occurs when a thrombus, fat or air embolus, amniotic fluid, or tumor tissue blocks one or more pulmonary arteries. These blockages originate in the venous system or the right side of the heart.EtiologyPE primarily arises from deep vein thrombosis (DVT) and other hypercoagulable states, such as inherited thrombophilias. Additional etiological factors include venous stasis, commonly seen in obesity, and endothelial injury from surgery and trauma. Less common causes include...
1.5K
Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
764
Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
764
Pulmonary Embolism I: Introduction
65
A blood clot, or thrombus, is a semi-solid mass composed of fibrin, platelets, and red blood cells. When it forms within a vessel, it can obstruct blood flow, known as thrombosis. If part of the clot detaches, it becomes an embolus that can travel and block distant vessels. When this occurs in the pulmonary arteries, it causes a condition known as pulmonary embolism (PE).Origin and ImpactMost often, the embolus originates from a thrombus in the deep veins of the lower limbs, a condition called...
65


