支气管肺功能失调患者体外生命支持的使用:一个单一中心病例系列
Goeto Dantes1, Carolyn Davis1, Katya Van Anderlecht2
1Department of Surgery, Emory University School of Medicine, Atlanta, GA, USA.
Perfusion
|July 24, 2024
概括
患有支气管肺功能失调 (BPD) 的早产婴儿的体外生命支持 (ECLS) 显示了与非BPD患者相比的生存和神经发育结果. 这项研究为ECLS候选人和BPD病例的家庭咨询提供了宝贵的见解.
科学领域:
- 儿科重症监护医药 儿科重症监护医药
- 新生儿科学 新生儿科学
- 肺部病理学 肺部病理学
背景情况:
- 支气管肺功能障碍症 (BPD) 是早产婴儿的慢性肺部疾病,通常与增加的呼吸道发病率有关.
- 需要呼吸支的BPD患者在历史上被认为是体外生命支 (ECLS) 的高风险患者,因为担心死亡率和术后并发症.
研究的目的:
- 评估诊断为BPD的早产儿科患者的结局,这些患者需要ECLS进行呼吸衰竭.
- 将经过ECLS的BPD患者的死亡率和长期神经发育结果与非BPD患者的历史数据进行比较.
主要方法:
- 在2010年1月至2022年6月期间,对2岁以下,早产 (<32周怀孕) 的BPD患者进行了单一中心的回顾性审查,这些患者需要ECLS进行呼吸衰竭.
- 收集人口统计,临床和ECLS特定数据.
- 评估神经发育和功能缺陷 (言语,语言,食,认知,听力,视觉,运动) 在医院出院后42个月的中位随访期.
主要成果:
- 19名患者符合纳入标准,出生时体重中位数为0.86公斤,妊娠年龄为26周.
- 脱管治疗的生存率为78.9% (15/19),医院出院的生存率为63.2% (12/19).
- 在幸存者中,42%需要家庭氧气,50%在1年的随访时有神经发育/行为问题.
结论:
- 需要ECLS的BPD早产患者的死亡率与呼吸衰竭的非BPD患者的死亡率相当.
- 这一BPD队列的长期神经发育结果也与非BPDECLS患者观察到的结果相似.
- 结果支持考虑BPD患者的ECLS,并提供有关风险和益处的知情家庭咨询的数据.
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