PLACE:在机械心脏循环支上对右心室衰竭进行多中心研究
Valeria Lo Coco1, Michele Di Mauro1, Antonio Loforte2,3
1From the Department of Cardio-Thoracic Surgery, Maastricht University Medical Centre, Maastricht, the Netherlands.
概括
暂时的机械心脏循环支持 (tMCS) 可以帮助急性右心室衰竭 (aRVF) 的患者. 虽然生存率低于50%,但年龄和器官功能等因素会影响结果.
科学领域:
- 心脏病学 心脏病学
- 临界护理医学 临界护理医学
- 机械循环支持 机械循环支持
背景情况:
- 孤立的急性右心室衰竭 (aRVF) 预后不佳,通常需要暂时的机械心脏循环支持 (tMCS).
- 了解治疗tMCS的aRVF患者的风险因素和结果对于改善患者管理至关重要.
研究的目的:
- 分析结果并确定用tMCS治疗的aRVF孤立患者的死亡风险因素.
- 在一个大型的国际队列中评估各种tMCS策略的有效性和安全性.
主要方法:
- 对国际多中心PLACE注册表 (2000-2020) 的回顾性分析.
- 包括644名与tMCS治疗的孤立aRVF患者,包括机械循环支持 (MCS) 和静脉动脉外体膜氧化 (VA-ECMO).
- 多变量后勤回归用于确定住院和3个月死亡率的预测因素.
主要成果:
- aRVF最常见的原因是LVAD植入后和心脏切除术后的休克.
- 在70.5%的患者中,tMCS的断奶成功;多器官衰竭是支持 (50.5%) 的首要死亡原因.
- 住院和3个月死亡率分别为45%和48.4%. 年龄,肺高血压的aRVF,高胆红素和寡尿/无尿是死亡风险因素,而LVAD后的aRVF与较低的早期死亡率有关.
结论:
- 暂时的机械心脏循环支持与孤立的aRVF患者的住院和3个月死亡率低于50%有关.
- 植入前的因素包括年龄,器官功能和特定的tMCS类型显著影响死亡风险.
- 与其他病因相比,LVAD植入后的aRVF似乎与更有利的早期预后有关.
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