在外周体外膜氧化过程中,假体膜血栓的发生率和结果
Pichoy Danial1,2, Claudio Zamorano1, Aude Carillion3
1Department of Cardiovascular and Thoracic Surgery, Institute of Cardiology, Sorbonne University, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France.
概括
在心脏切除术后心脏性休克 (PCCS) 置换手术后,外周静脉动脉外体膜氧化 (pVA-ECMO) 具有较低的假体血栓形成风险. 将pVA-ECMO与大动脉内气球相结合,进一步降低了这种风险,并提高了生存率.
科学领域:
- 心血管外科心血管外科
- 关键护理医学 关键护理医学
- 生物医学工程 生物医学工程
背景情况:
- 心脏切除术后的心脏性休克 (PCCS) 在置换手术后经常需要外周静脉动脉外体膜氧化 (pVA-ECMO).
- 假肢血栓是与pVA-ECMO在这个患者群体中相关的重大并发症.
研究的目的:
- 为了确定在门置换后接受PCCS的pVA-ECMO治疗的患者中,假体膜血栓形成的发生率和结果.
- 为了确定与这个队列中的假血栓相关的风险因素.
主要方法:
- 追溯研究包括接受PCCS门后置换pVA-ECMO的成年患者 (2015年1月 - 2019年10月).
- 结果变量包括假血栓形成,30天和住院存活率以及ECMO相关的不良事件.
主要成果:
- 在接受门置换并接受pVA-ECMO的152名患者中,有9人患有假血栓形成 (30天发生率为7.5%).
- 与pVA-ECMO单独 (1.4%对13.7%,P=0.021) 相比,pVA-ECMO加上大动脉内气球 (IABP) 的假体血栓的累积发病率明显较低.
- 与pVA-ECMO一起使用IABP是预防医院死亡的独立保护因素 (OR=0.180,P=0.001).
结论:
- 周围股骨-股骨VA-ECMO用于PCCS门后置换与急性门血栓形成的风险较低有关.
- 同时使用大动脉内气球显著降低了假体血栓的风险,并改善了医院生存率.
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