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在接受体外膜氧化治疗的患者中,高氧和死亡率之间的关联:系统性审查和元分析
Maoni Zeng1, Xiangui Lv2, Junchen Zhu2
1Department of Obstetrics and Gynecology Intensive Care Unit, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China.
Journal of critical care
|November 14, 2025
概括
在体外膜氧化 (ECMO) 期间,高动脉氧水平 (过氧) 与成人患者的死亡率增加有关. 需要进一步的研究来证实这些发现,并确定最佳的氧气目标.
科学领域:
- 关键护理医学 关键护理医学
- 心血管研究研究心血管研究
- 呼吸系统医学 呼吸系统医学
背景情况:
- 在患者体外膜氧化 (ECMO) 的高氧化和死亡率之间的关系是辩论.
- 这项研究系统地审查了动脉过氧对成年ECMO患者死亡率的影响.
研究的目的:
- 系统地评估成年ECMO患者的动脉过氧和死亡率之间的关联.
- 综合现有关于高氧和ECMO结果研究的证据.
主要方法:
- 按照PRISMA指南进行系统审查和元分析.
- 搜索了主要的数据库 (PubMed,科学网,Embase,Cochrane图书馆) 相关研究到2025年4月.
- 使用I2统计计算了28天死亡率和评估异质性的聚合几率比率.
主要成果:
- 包括12项研究,涉及17529名参与者.
- 过氧显著增加了死亡率 (OR 1.41,95% CI 1.22-1.64).
- 观察到PaO2≥200 mmHg和≥300 mmHg的较高死亡率,特别是在VA-ECMO和ECPR中;在VV-ECMO中没有显著的关联.
结论:
- 早期高氧化,特别是高PaO2水平,与成年ECMO患者,特别是VA-ECMO和ECPR患者的死亡率增加有关.
- 实质性的异质性,混性和有限的随机证据需要谨慎.
- 未来的随机试验对于在ECMO中定义最佳氧化目标至关重要.
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