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经过七天的静脉静脉外体膜氧化支持后的预后
Felix A Rottmann1, Rebecca Book2, Alexander Supady2
1Department of Medicine IV - Nephrology and Primary Care, Medical Center and Faculty of Medicine, University of Freiburg, Freiburg, Germany.
通过在第七天分析呼吸和V-V ECMO参数,对静脉静脉外体膜氧化 (V-V ECMO) 患者的预后得到改善. 较高的参数值与医院生存率有很强的相关性,提供了潜在的预后标记.
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.
- 呼吸系统生理学 呼吸系统生理学
背景情况:
- 对静脉静脉外体膜氧化 (V-V ECMO) 患者的预后具有挑战性,特别是在长期支持的情况下.
- 准确的预后指标对于指导患者护理和临床决策至关重要.
- 本研究的重点是评估需要V-V ECMO至少七天的患者的结果.
研究的目的:
- 在接受V-V ECMO的患者中确定医院生存的预测因素.
- 评估第七天呼吸道和V-V ECMO参数对预后的有用性.
- 确定"生存有利率"是否可以歧视结果.
主要方法:
- 一项对299名需要V-V ECMO进行呼吸衰竭的患者进行的回顾性队列研究.
- 在仍在支持的患者中,在第七天分析呼吸机和V-V ECMO参数.
- 根据定义的"生存有利率"进行分层,以预测医院生存率.
主要成果:
- 在所有患者中,住院生存率为44.8%,在第七天接受V-V ECMO的人中为45.1%.
- 六个参数 (通风器FiO2,潮体积,合规;V-V ECMO血流,扫气流,O2分数) 显著预测了生存率 (p ≤0.015).
- 具有多个参数高于有利性边际的患者的生存率明显更高 (67.5%),相比于没有 (13.8%).
结论:
- 呼吸道和V-V ECMO参数在第七天,当超过一个有利率时,与医院生存有很强的相关性.
- 只有少数所有预测因素低于边际的患者存活下来.
- 第七天为V-V ECMO预测提供了一个潜在的有用,但不是最终的时间点.
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