长期ECMO的预测和预后因素:一个多中心的回顾性研究.
Kota Hoshino1,2,3, Naofumi Bunya4, Jun Hamaguchi5
1Emergency and Critical Care Center, Okinawa Prefectural Nanbu Medical Center and Children's Medical Center, 118-1 Arakawa, Haebaru-cho, Shimajiri, Okinawa, 901-1193, Japan. hoshinoqq@yahoo.co.jp.
概括
在体外膜氧化 (ECMO) 之前,较低的阳性终端呼气压 (PEEP) 预测严重的COVID-19患者的长期ECMO. 21日的顺序器官衰竭评估 (SOFA) 评分预测了这些长期ECMO病例的生存率.
科学领域:
- 关键护理医学 关键护理医学
- 呼吸系统医学 呼吸系统医学
- 传染性疾病 传染性疾病
背景情况:
- 在COVID-19大流行期间,体外膜氧化 (ECMO) 的使用增加.
- 长时间的ECMO与高资源使用和更差的患者结局有关.
- 确定长期ECMO的预测因素和预后因素至关重要.
研究的目的:
- 在严重的COVID-19患者中确定长期ECMO的预测因素.
- 探索需要长期ECMO的患者的预后指标.
- 将预后性能与现有的评分系统进行比较.
主要方法:
- 在日本重症COVID-19的毒性ECMO的多中心回顾性研究 (2020年1月-2021年12月).
- 长期ECMO的定义为≥21天.
- 在ECMO第21天分析了基线特征,ECMO前因素和预后因素.
主要成果:
- 在121名患者中,32%的患者需要长时间的ECMO.
- 在ECMO前较低的阳性末尾呼气压 (PEEP) 预测了长时间的ECMO (AUC:0.70).
- 在ECMO第21天的顺序性器官衰竭评估 (SOFA) 评分预测了住院生存率 (AUC:0.82),并且表现优于其他评分.
结论:
- 低的ECMO前PEEP是长期ECMO的一个关键预测因素.
- 21日的SOFA评分是长期ECMO患者生存的强有力的独立预测指标.
- 持续的器官功能障碍评估有助于预后评估和临床决策.
相关概念视频
Factors Affecting Pulmonary Ventilation
2.8K
Besides the pressure difference between the external environment and the lungs, the airflow rate and ease of pulmonary ventilation are also influenced by three other factors: surface tension of the fluid in the alveoli, compliance of the lungs, and airway resistance.
Alveolar Surface Tension
The alveolar fluid lines the luminal surface of the alveoli and exerts a force called surface tension. This force is caused by the polar water molecules in the liquid being more strongly attracted to each...
Alveolar Surface Tension
The alveolar fluid lines the luminal surface of the alveoli and exerts a force called surface tension. This force is caused by the polar water molecules in the liquid being more strongly attracted to each...
2.8K
Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
281
Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
281


