对于通道阻断剂中毒的体外膜氧化:一个多中心的回顾性注册表审查
April Slamowitz1, Todd Sweberg1, Katie Labgold2,3
1From the Department of Pediatric Critical Care, Cohen Children's Medical Center, Northwell Health, New Hyde Park, New York.
身体外膜氧化 (ECMO) 是严重通道阻塞 (CCB) 毒性的重要救援疗法. 儿科患者的生存率高于成年人,年龄较小和没有心脏骤停改善了结果.
科学领域:
- 心脏病学 心脏病学
- 毒理学 毒理学 毒理学
- 关键护理医学 关键护理医学
背景情况:
- 通道阻塞 (CCB) 毒性可能导致严重的心脏性休克和循环崩.
- 体外膜氧化 (ECMO) 是一种潜在的救援疗法,用于耐火性CCB毒性.
- 关于ECMO结果的数据有限,特别是比较儿科和成年人群.
研究的目的:
- 为了分析儿童与成年患者的生存结果,使用ECMO治疗的CCB毒性.
- 为了确定与需要ECMO用于CCB毒性患者的生存相关的因素.
主要方法:
- 对体外生命支持组织 (ELSO) 注册表 (2015-2023) 的回顾性分析.
- 纳入标准:年龄大于28天的CCB毒性需要ECMO的患者.
- 主要结局:存活到出院. 统变物流回归用于确定与生存相关的因素.
主要成果:
- 儿科患者的总生存率为80%,成人为63% (p=0.0536).
- 静脉动脉ECMO是主要的配置 (90%).
- 增加的年龄,较低的动脉pH值,ECMO前的心脏骤停和体外心肺复苏 (ECPR) 与较低的生存几率有关.
结论:
- 对于严重的CCB毒性来说,ECMO是一种越来越多地使用的救援疗法.
- 与成人相比,儿童患者通常经历了更好的结果.
- 年龄较小,动脉pH值保持良好,没有ECMO前心脏骤停是有利的预后指标.
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