在体外膜氧化解管后发烧:感染,血栓形成还是仅仅生理?
Benjamin Assouline1, Gianlucca Belli1, Karim Dorgham2
1Sorbonne Université, Service de Médecine Intensive Réanimation, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique - Hôpitaux de Paris, France.
在体外膜氧化 (ECMO) 脱后发烧很常见,影响了44%的患者. 感染和血栓形成是主要原因,需要进一步调查,而不仅仅是简单的炎症反应.
科学领域:
- 关键护理医学 关键护理医学
- 心血管外科心血管外科
- 传染性疾病 传染性疾病
背景情况:
- 发烧是体外膜氧化 (ECMO) 脱管后的常见并发症.
- 了解脱后发烧的发病率和病因对于患者管理至关重要.
研究的目的:
- 为了确定ECMO脱后发烧的发病率.
- 确定成年患者中脱后发烧的主要原因.
主要方法:
- 对成年ECMO患者的回顾性分析成功奶.
- 从48小时前到5天后的每日核心温度监测.
- 发烧原因的分类 (感染,血栓形成,未知) 和在患者子集中的细胞因子分析.
主要成果:
- 在123名患者中,54%的患者出现了发烧.
- 感染是最常见的原因 (72%),其次是血栓形成 (11%).
- 长时间的ECMO持续时间和ICU停留与更高的感染风险有关;发烧和无发烧组之间的细胞因子概况没有差异.
结论:
- 脱后发烧是一种显著的临床事件,主要是由感染或血栓形成引起的.
- 应彻底调查ECMO脱后的发烧,而不是假定是良性炎症反应.
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