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在6个月后体外膜氧化病例和死亡或残疾病例的医院级体积

Atacan D Ertugrul^1,2, Ary Serpa Neto^1,2,3,4,5, Bentley J Fulcher^1,2

¹Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, Australia.

Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine

|January 9, 2025

概括

身体外膜氧化 (ECMO) 中心体积在六个月后没有影响患者的死亡或残疾结果. 这表明协调护理模型可能会减轻ECMO中的体积-结果关系.

科学领域:

关键护理医学关键护理医学
支持心肺血管的支持.
医疗保健服务研究医疗服务研究

背景情况:

身体外膜氧化 (ECMO) 是一种高风险的生命支持干预.
在ECMO中心体积和患者的结果,特别是长期功能状态之间的关系仍然不清楚.
了解体积与结果的关系对于优化ECMO中的患者护理和资源配置至关重要.

研究的目的:

调查体外膜氧化 (ECMO) 中心每年使用量与长期死亡和残疾结果之间的关联.
分析不同ECMO模式之间的这种关系:静脉静脉 (VV),静脉动脉 (VA) 和体外心肺复苏 (ECPR).

主要方法:

使用双国ECMO注册表 (EXCEL) 嵌入注册表的观察队列研究.
包括接受ECMO的患者,但不包括接受心脏/肺移植的患者.
收集了人口统计和临床数据,通过电话采访评估了六个月的结果. 多变量分析按医院每年ECMO数量分层 (大体积中心为30例).

主要成果:

在高容量和低容量ECMO中心之间,没有观察到六个月死亡或新增残疾的显著差异.
这一发现适用于VV-ECMO (OR: 1.09),VA-ECMO (OR: 1.10) 和ECPR-ECMO (OR: 1.38).
敏感性分析,包括患者转移,证实没有体积与结果关系.

结论:

根据澳大利亚和新西兰的ECMO中心数量,六个月死亡或残疾没有明显的差异.
观察到的体积与结果关系的缺乏可能归因于区域协调护理模式.
这种模式包括患者转移和中心间培训,有可能在不同体积中心标准化护理.

关键词:

急性呼吸应急综合征 (ARDS) 是一种急性呼吸应急综合征.麻醉和重症监护的重症监护心脏衰竭是因为心脏衰竭.心脏 perfusion 是一种心脏 perfusion 的方法.紧急医疗紧急医疗身体之外的生命支持.重症监护室的重症监护室是重症监护室的重症监护室.提供氧气的运输.呼吸系统的功能.复苏复苏复苏复苏复苏

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