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评估体外膜氧化支持患者的静脉血栓风险:系统性审查和元分析
Yan Zhu1, Mei-Juan Lan1, Jiang-Shu-Yuan Liang1
1Department of Nursing, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.
概括
静脉血栓事件在体外膜氧化 (ECMO) 患者中很常见,影响48%的人. 较长的ECMO持续时间,不良的抗凝血控制和管类型增加了风险.
科学领域:
- 心脏病学 心脏病学
- 临界护理医学 临界护理医学
- 血液学 血液学 血液学
背景情况:
- 静脉血栓事件 (VTE) 是需要体外膜氧化 (ECMO) 的患者的重大并发症.
- 了解这种人群中VTE的患病率和风险因素对于改善患者的治疗结果至关重要.
研究的目的:
- 系统地审查和对现有文献进行元分析,以确定接受ECMO的患者中VTE的综合流行率.
- 为了确定与ECMO患者VTE发病率增加相关的关键风险因素.
主要方法:
- 进行了全面的系统审查和元分析.
- 在多个数据库 (PubMed,Cochrane,Embase等) 进行了搜索. 对于在2023年11月25日之前发布的相关病例控制和队列研究.
- 包括19项与10,767名参与者的研究,以计算风险因素的综合流行率和赔率比率.
主要成果:
- 在ECMO患者中,VTE的综合患病率为48% (95% CI 0.37-0.60).
- 重要的风险因素包括更长的ECMO持续时间 (OR 1.08),异常抗凝监测 (OR 1.02) 和特定的ECMO管类型 (OR 1.77).
- 在各个研究中观察到很高的异质性 (I2 > 49%).
结论:
- 在ECMO支持的患者中,VTE的患病率很大.
- 临床医生应警VTE风险因素,包括长时间的ECMO支持,低于最佳的抗凝管理和管策略.
- 进一步的研究可能是有必要的,以优化VTE预防和治疗在这个高风险群体.
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