儿科毒性异体膜氧化使用双流体或多位管道的结果:异体生命支持数据库研究,2000-2019年
Jessica A Barreto1, Pingping Qu2, Ravi R Thiagarajan1
1Division of Cardiac Critical Care, Department of Cardiology, Boston Children's Hospital, Boston, MA.
概括
对于儿科毒性体外膜氧化 (ECMO) 的双光膜 (DL) 和多站点导管策略显示出类似的死亡率和并发症. 这项研究发现,在儿童的两种ECMO管方法之间,结果没有显著差异.
科学领域:
- 儿科重症监护医药 儿科重症监护医药
- 身体外支持技术 身体外支持技术
- 通过心肺绕道术 (cardiopulmonary bypass) 进行心肺绕道.
背景情况:
- 静脉外体膜氧化 (ECMO) 是对儿科呼吸衰竭的重要生命支持疗法.
- 导管策略,特别是双光 (DL) 与多站点方法,是ECMO有效性和安全性的关键因素.
- 在儿科患者群体中对这些策略的比较数据有限.
研究的目的:
- 为了比较儿科毒性ECMO的双光门 (DL) 和多站点管之间的死亡率.
- 评估DL和多站点ECMO之间需要额外的管和并发症频率的差异.
- 分析儿科患者的管策略与ECMO持续时间之间的关联.
主要方法:
- 一个多中心的回顾性研究,利用体外生命支持组织 (ELSO) 注册表.
- 包括2000年至2019年期间接受毒性ECMO的儿科患者 (28天至18岁).
- 进行了单变量和多变量回归分析,以评估与管策略相关的结果.
主要成果:
- 分析了2034名儿科患者的队列;71%接受了DL吸管.
- 没有发现DL或多站点管与住院死亡率 (aRR1.1;p=0.70) 之间有显著的关联.
- ECMO持续时间,需要额外的管,和整体并发症是相似的,在多站组中,神经死亡的确定更频繁.
结论:
- 在2000-2019年的儿科毒性ECMO中,管类型 (DL与多位) 并没有显著影响死亡率或主要结果.
- 双光和多位管策略似乎是儿科毒性ECMO的可行选择.
- 进一步的研究可能会探索特定的患者亚组或改进管技术以优化结果.
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