在肺移植中延迟关闭的临床结果
Arvind Bakthavatsalam1, Billanna Hwang2, Michael S Mulligan2
1Department of Surgery, Vassar Brothers Medical Center, Nuvance Health, Poughkeepsie, New York.
Transplantation proceedings
|December 6, 2024
概括
肺移植 (LTx) 中的延迟胸关闭 (DSC) 与更长的住院时间和更糟糕的生存率有关. 虽然不是唯一的原因,但DSC可能表明潜在的患者因素影响LTx接受者的结果.
科学领域:
- 心胸外科手术 心胸外科手术
- 肺部医学 肺部医学
- 移植医学 移植医学
背景情况:
- 肺移植 (LTx) 是对末期肺病的重要治疗方法.
- 延迟关闭 (DSC) 在心脏手术中用于不稳定的患者,但其在LTx中的作用尚不清楚.
研究的目的:
- 调查DSC对肺移植接受者的临床结果的影响.
- 为了比较在LTx后接受DSC和初级胸关闭 (PSC) 的患者之间的结果.
主要方法:
- 从2010年至2018年对370名LTx患者的回顾性分析.
- 患者被分为DSC (n=20) 和PSC (n=350) 组.
- 评估的结果包括住院时间 (LOS),ICU LOS,呼吸器持续时间和整体存活率.
主要成果:
- DSC组的医院LOS (23.0 vs 15.0天),ICU LOS (16.0 vs 5.0天) 和呼吸器持续时间 (9.0 vs 1.0天) 显著更长 (P < .01).
- 卡普兰-梅尔生存分析显示,与PSC组相比,DSC组的1,3,5年生存率较低 (75.0%,60.0%,55.0%),而PSC组的91.4%,82.6%,75.1% (P = .019).
结论:
- 在LTx中观察到延迟的胸关闭,这与延长的恢复和较差的存活率有关.
- DSC可以作为患者特异性因素的指标,有助于肺移植后不良结果.
相关概念视频
Tracheostomy Decannulation
112
Tracheostomy decannulation is a significant milestone in the liberation of mechanically ventilated patients. Despite its importance, there is no universally accepted protocol for this procedure. This demands an evidence-based, individualized approach.
Description of the Procedure
Decannulation refers to the permanent removal of the tracheostomy tube, signaling the resolution of the condition that initially necessitated the tracheostomy. The process requires a well-coordinated interplay between...
Description of the Procedure
Decannulation refers to the permanent removal of the tracheostomy tube, signaling the resolution of the condition that initially necessitated the tracheostomy. The process requires a well-coordinated interplay between...
112
Flail Chest-II
160
Managing flail chest, a condition characterized by a segment of the chest wall moving independently from the rest of the thoracic cage, requires a comprehensive approach. It includes a thorough assessment of the patient's condition, a diagnostic evaluation to determine the extent of the injury, and the implementation of appropriate medical interventions tailored to the individual's needs.
Assessment:
1. Clinical Evaluation:
History:
Assessment:
1. Clinical Evaluation:
History:
160


