使用MANTA装置进行体外膜氧化的穿皮解管:一个真实世界的单中心体验
Ioannis Milioglou1, Alice Qian2, Pedro Rafael Vieira de Oliveira Salerno2
1Department of Cardiology, University Hospitals Cleveland Medical Center, Cleveland, OH 44106, United States. ioannismilioglou@gmail.com.
World journal of cardiology
|November 4, 2024
概括
曼塔血管关闭装置 (VCD) 有效地帮助静脉外体膜氧化 (VA-ECMO) 脱管,在大多数患者中实现血静. 虽然通常是安全的,但建议警潜在的缺血并发症.
科学领域:
- 心血管医学 心血管医学
- 干预心脏病学 干预心脏病学
- 关键护理医学 关键护理医学
背景情况:
- 曼塔血管关闭装置 (VCD) 是一种用于大孔股骨通道的新型血液静止方法.
- 目前关于在静脉外体膜氧化 (VA-ECMO) 脱管中使用MANTA VCD的现有数据有限.
研究的目的:
- 评估使用MANTA VCD进行皮肤穿透VA-ECMO脱管的单中心经验.
- 在这个特定的患者群体中评估MANTA VCD的安全性和有效性.
主要方法:
- 在19名接受骨VA-ECMO用MANTA VCD脱的成年患者进行了回顾性队列研究 (2021年1月至2023年10月).
- 纳入标准:长时间的VA-ECMO (>24小时).
- 评估结果:死亡率,血液静止,出血,四肢缺血和部位感染.
主要成果:
- 在19名患者中,有17名患者存活到出院.
- 在所有患者中,MANTA VCD的部署成功,有10次床边和9次OR手术.
- 在17名患者中,在5分钟内实现了完整的血液静止; 2人需要额外的手动压缩.
- 两名患者出现了需要干预的下肢缺血症;没有报告发生部位感染.
结论:
- MANTA VCD是一种简单,安全和有效的穿皮技术,用于VA-ECMO脱,使床边手术成为可能.
- 与选择性手术相比,观察到更高的脱后缺血性并发症发生率.
- 意识到缺血并发症风险和监测远端脉冲对于管理至关重要.
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