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昏迷患者的患病率和神经结果与体外膜氧化

Cheng-Yuan Feng¹, Anna Kolchinski², Shrey Kapoor²

¹Division of Neurosciences Critical Care, Departments of Neurology and Neurosurgery, and Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Critical Care Medicine and TriHealth Neuroscience Institute, Cincinnati, OH.

Journal of cardiothoracic and vascular anesthesia

|July 26, 2024

概括

在体外膜氧化 (ECMO) 患者中昏迷是常见的,并且与神经学结果不佳有关. 置换疗法是ECMO期间昏迷的重要危险因素.

科学领域:

关键护理医学关键护理医学
神经学神经学
支持心肺血管的支持.

背景情况:

昏迷是需要体外膜氧化 (ECMO) 的患者的一个关键问题.
了解ECMO患者昏迷的发生率和结果对于改善护理至关重要.

研究的目的:

调查经过ECMO的昏迷患者的患病率,风险因素和住院结果.
在静脉动脉 (VA) 和静脉 (VV) ECMO中确定与昏迷相关的因素.

主要方法:

在高等学术医院进行了回顾性观察性研究.
包括230名在2017年11月至2022年4月期间接受VA或VVECMO的成年患者.
基于格拉斯哥昏迷表得分的定义昏迷,并没有24小时的镇静中断.

主要成果:

在休止24小时镇静药后昏迷 (昏迷休止) 发生在56.5%的VA-ECMO患者和52.2%的VV-ECMO患者中.
连续镇静期间的昏迷 (昏迷) 影响了50.5%的VA-ECMO和17.2%的VV-ECMO患者.
在VA和VVECMO组中,昏迷与不良的神经结果相关 (修改的兰金尺度4-6).
昏迷只在VA-ECMO组中与糟糕的结果有关.
脏替代疗法是昏迷的独立风险因素.

结论:

昏迷是ECMO患者经常发生的情况,预测出院时会出现不良的神经结果.
需要接受脏替代疗法是昏迷的重要独立风险因素.

关键词:

严重的脑损伤是急性脑损伤.在昏迷中昏迷,昏迷中昏迷.身体外膜氧化氧化修改的排名规模修改的排名规模神经学的结果.镇静镇静是一种镇静.

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