当代实践和四肢结果在外周静脉动脉外体膜氧化在一个大容量单一机构
Robert Matthews1, Adam Surti1, Donna Bahroloomi2
1Department of General Surgery, Cedars-Sinai Medical Center, Los Angeles, CA.
Journal of vascular surgery
|November 16, 2025
概括
外周静脉外体膜氧化 (VA-ECMO) 接入实践发展,显示肢体缺血减少,超声指导和远端 perfusion 导管的使用增加. 这些附加剂可以改善VA-ECMO患者的血管结果.
科学领域:
- 心血管外科心血管外科
- 关键护理医学 关键护理医学
- 血管外科 血管外科
背景情况:
- 外周静脉外体膜氧化 (VA-ECMO) 是严重循环衰竭的救生疗法.
- 血管并发症,特别是四肢缺血,是外围VA-ECMO管道的重大问题.
- 辅助技术可以减轻这些血管并发症.
研究的目的:
- 在8年的时间里分析外围VA-ECMO管道技术的演变.
- 评估诸如超声指导,远端 perfusion 导管和断管策略对血管并发症的影响.
- 评估这些变化对患者结果的影响,特别是肢体缺血.
主要方法:
- 在第三级中心 (2017-2024) 接受外围VA-ECMO的447名患者的回顾性图表审查.
- 主要终点:四肢缺血需要断层切除或截肢.
- 二级终点包括各种血管并发症;分析比较了早期与当代实践时期.
主要成果:
- 总体肢体缺血需要切或截肢发生在1.8%的患者中.
- 周围动脉疾病是血管并发症的危险因素 (OR,2.19).
- 当代时期 (2023-2024) 显示了超声波指导 (88%),远端 perfusion 导管 (90%) 和Fogarty 气球在断管时 (65%) 的使用增加,与肢体缺血显著减少相关 (3.5%与早期时期的8.2%相比).
结论:
- 周边VA-ECMO管实践已经发展,并越来越多地采用特定的辅助器.
- 当代队列表明四肢缺血的显著减少,表明结果有所改善.
- 更多地使用超声波指导,远端 perfusion 导管和Fogarty 气球在断管时可能有助于改善血管结果.
相关概念视频
Extracorporeal Removal of Drugs: Hemoperfusion and Hemofiltration
184
Hemoperfusion and hemofiltration are critical techniques in medical treatments to eliminate accumulated drugs, metabolites, and electrolytes from the bloodstream. These methods are particularly vital in cases of accidental poisoning and drug overdose.Hemoperfusion involves passing blood through an adsorbent material to remove unwanted substances. The main adsorbents used in hemoperfusion include activated charcoal and Amberlite resins. Activated charcoal can adsorb both polar and nonpolar...
184
Venous Return
11.6K
The circulatory system plays a crucial role in ensuring the optimal functioning of the human body. One of its critical components is venous return - the process that completes the blood circulation cycle. This article will delve into the concept of venous return, how it works, and its significance to our health.
What is Venous Return?
Venous return refers to the rate at which blood flows back to the heart from the body's peripheral veins. It's an integral part of the circulatory system...
What is Venous Return?
Venous return refers to the rate at which blood flows back to the heart from the body's peripheral veins. It's an integral part of the circulatory system...
11.6K
Hemodialysis II: Procedure and Complications
590
DialyzersA hemodialysis (HD) dialyzer is a plastic cartridge containing thousands of parallel hollow fibers, which serve as semipermeable membranes. These fibers are typically made from cellulose-based or other synthetic materials. During HD, blood is pumped into the top of the cartridge and distributed among these fibers. Simultaneously, dialysis fluid, known as dialysate, is introduced into the bottom of the cartridge, bathing the outside of the fibers. Across the semipermeable membrane,...
590
Peritoneal Dialysis II: Peritoneal Dialysis Systems and Complications
503
Peritoneal dialysis (PD) is a medical process that removes waste products and excess fluid from the body using the peritoneal membrane as a natural filter.Peritoneal Dialysis MethodsSeveral methods can be used for peritoneal dialysis, including Acute Intermittent Peritoneal Dialysis, Continuous Ambulatory Peritoneal Dialysis, and Automated Peritoneal Dialysis, also known as Continuous Cyclic Peritoneal Dialysis.Acute Intermittent Peritoneal Dialysis (AIPD) is used for patients with uremic...
503


