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心脏手术后ECMO支持患者的血管并发症

Cagdas Baran¹, Evren Ozcinar¹, Ahmet Kayan²

¹Department of Cardiovascular Surgery, Heart Center, Cebeci Hospitals, Ankara University School of Medicine, 06230 Ankara, Turkey.

Journal of clinical medicine

|September 14, 2024

概括

与穿皮方法相比,体外膜氧化 (ECMO) 放置的开放技术可以减少血管血栓栓塞和血液瘤. 然而,它增加了出血的风险,对于这两种ECMO技术的总体死亡率相似.

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:

在心脏手术后需要体外膜氧化 (ECMO) 的患者中,血管并发症是一个重大问题.
了解与不同ECMO管道技术相关的风险对于患者的治疗结果至关重要.

研究的目的:

为了在心脏切除术后的患者中比较VA-ECMO导管切割的穿皮和开放的股骨切割技术之间的血管并发症.
评估管方法对血栓栓塞事件,出血,血瘤和感染的影响.

主要方法:

通过外周通道进行VA-ECMO的84名心脏切除术后患者的回顾性分析.
通过皮肤 (n=52) 和开放的股骨切口 (n=32) ECMO安置组之间的血管并发症的比较.
对并发症率的统计分析,包括血栓栓塞,血瘤,出血,泄漏,伤口感染和修订.

主要成果:

皮肤穿ECMO安置显示,血管血栓栓塞和血液瘤的发生率明显较高 (p <0.05).
开放的股骨切口技术与明显增加的出血和泄漏有关 (p = 0.04).
两组之间没有观察到伤口感染或 inguinal revisions 的显著差异. 血管缺血的死亡率为81.2%.

结论:

与穿皮方法相比,VA-ECMO通道的开放技术可能会降低血栓栓塞事件和血液瘤的风险.
穿皮技术可能与更高的出血和泄漏风险有关.
这两种管方法在整体住院死亡率和伤口感染方面表现出相似的结果.

关键词:

心脏外科手术的心脏手术身体外膜氧化氧化周围血管疾病周围血管疾病

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