在新生儿和儿童体外膜氧化过程中进行大量单中心试验
Caroline Holton1, Johanna Orrick2, Debra Newton2
1From the Division of Critical Care, Department of Pediatrics, University of Missouri-Kansas City and Children's Mercy Hospital, Kansas City, Missouri.
概括
在特定的儿科患者身上进行外体膜氧化 (ECMO) 是可行的和安全的. 这种方法可以减少肺部损伤并改善患者的治疗结果,在被抽管的患者中观察到更高的生存率.
科学领域:
- 儿童重症监护医疗
- 对心肺的支持
- 新生儿重症监护
背景情况:
- 在新生儿和儿科患者接受体外膜氧化 (ECMO) 时,可预防呼吸器诱导的肺损伤,减少镇静剂暴露,并促进恢复.
- 关于在儿童群体中使用ECMO时切口术的可行性和安全性的数据有限.
研究的目的:
- 描述单个中心在ECMO上输出患者的经验.
- 评估该队列中与输出管相关的结果和并发症.
主要方法:
- 从2013年到2022年接受ECMO的患者的回顾性队列研究.
- 对心脏病,儿科和新生儿重症监护病房的抽管和未抽管ECMO患者的分析.
- 对生存率和并发症概况进行比较.
主要成果:
- 40名患者 (ECMO运行的8. 6%) 在ECMO上进行了抽管,代表了最大的单中心儿科队列.
- 抽管患者年龄较大,接受肺部支,经过更长时间的ECMO治疗.
- 脱管患者的存活率为75%,明显高于未脱管组 (p=0. 044).
- 经过调整后的分析显示,外管治疗患者的胃肠道出血和连续置换疗法 (CRRT) 增加,但其他主要并发症没有增加.
结论:
- 在特定的儿科患者中, ECMO 输出管是可行的和安全的策略.
- 这种做法与医院出院的生存率有所改善.
- 虽然一些并发症如胃肠道出血和CRRT使用更频繁,但整体主要并发症并没有增加.
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