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血管闭塞装置与骨静脉外体膜氧化器的开放解管器
Aakash Shah1, Justin Robinson1, Joshua Leibowitz1
1Division of Cardiac Surgery, Department of Surgery, University of Maryland School of Medicine, Baltimore, Maryland.
The Annals of thoracic surgery
|December 26, 2024
概括
与开放手术相比,MANTA血管闭塞装置在股骨静脉外体膜氧化 (VA ECMO) 脱管后显著减少下肢并发症. 这允许更安全的床边脱,穿皮闭合证明与手动压力一样有效.
科学领域:
- 心血管外科心血管外科
- 临界护理医学 临界护理医学
- 血管接入 血管接入
背景情况:
- 传统的股骨静脉 (VA) 外体膜氧化 (ECMO) 解管需要开放的股骨切割.
- 穿皮脱方法正在出现,但支持其有效性的证据有限.
- 这项研究将MANTA血管关闭装置与大腿VA ECMO的开放式断管装置进行比较.
研究的目的:
- 在接受大腿VA ECMO的患者中,比较MANTA血管关闭装置和开放式断管术之间的下肢并发症发生率.
- 评估表面大腿动脉 (SFA) 关闭方法的有效性,包括手动压力与穿皮关闭装置的有效性.
主要方法:
- 从股骨VA ECMO脱的患者的回顾性审查 (2018年1月-2023年1月).
- 排除标准包括非穿皮管或没有MANTA装置的穿皮脱管.
- 主要结局:下肢并发症. 二次结果:SFA关闭方法的比较 (手动压力与皮肤穿透).
主要成果:
- 160名患者接受了开放式脱; 94名患者接受了MANTA脱.
- 曼塔脱治疗显示,下肢并发症相对减少了46% (26.1%与39.6%相比).
- 手动压力和穿皮关闭之间SFA并发症没有显著差异 (14.4%vs10.7%).
结论:
- 与大腿VA ECMO的开放式解相比,MANTA解显著减少了下肢并发症.
- 曼塔设备有助于安全的床边脱.
- 通过皮肤进行的SFA闭合证明了与手动压力相当的结果.
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