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在心脏移植手术后出现严重的术后出血.

Alexandre Mansour1, Adrien Bougle2, Marion Turpin3

  • 1Department of Anesthesia and Critical Care, Pontchaillou, University Hospital of Rennes, Univ Rennes, CHU Rennes, CIC 1414 (Centre d'Investigation Clinique de Rennes), Inserm, IRSET, UMR_S 1085, FHU SUPORT, F35000 Rennes, France. ORCID0000-0001-8955-2407.

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严重的出血并发症发生在25%的心脏移植接受者中,增加了一年死亡率. 机械心脏支持和心肺旁路术的持续时间是移植后出血的关键风险因素.

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科学领域:

  • 心脏病学 心脏病学
  • 移植手术 移植手术
  • 关键护理医学 关键护理医学

背景情况:

  • 手术后出血是心脏手术中常见的问题.
  • 然而,其发病率,风险因素和心脏移植后的后果尚未明确定义.
  • 严重的出血并发症显著影响患者的结果.

研究的目的:

  • 确定成年心脏移植接受者严重出血并发症的发生率.
  • 为了确定与严重的手术后出血相关的危险因素.
  • 评估严重出血对一年死亡率的影响.

主要方法:

  • 在2015-2022年期间,法国两个中心对成年心脏移植患者进行了一项观察性研究.
  • 严重出血被定义为使用外科手术期间出血的普遍定义 (UDPB) 评分≥3.
  • 使用多变量后勤和考克斯回归模型来识别风险因素并评估死亡率的影响.

主要成果:

  • 在446名患者中,112名 (25%) 患有严重出血.
  • 风险因素包括长期的机械心脏支持,手术前血红蛋白降低,心肺旁路术 (CPB) 持续时间更长.
  • 严重出血与一年死亡率增加有关 (35%对13%,调整HR 1.91).

结论:

  • 心脏移植后严重出血并发症的发生率很高,特别是在机械循环支持患者中.
  • 这些出血事件显著增加了患者的发病率和死亡率.
  • 需要进行进一步的研究,以制定有效的预防策略,以预防心脏移植后出血.