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成年患者的结果,需要多次运行体外膜氧化
Nathan D Peffley1, Jennifer Lee1, Richard K Patch1
1Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN.
Journal of cardiothoracic and vascular anesthesia
|February 13, 2026
概括
在成年人中,多次的体外膜氧化 (ECMO) 支持显示,如果患者患有急性功能衰竭,心脏切除术后心脏性休克或40岁以上,其生存率很低. 患有先天性心脏病的年轻患者有更好的结果.
科学领域:
- 心脏病学 心脏病学
- 关键护理医学 关键护理医学
- 心血管外科心血管外科
背景情况:
- 在单次住院期间,多次体外膜氧化 (ECMO) 在成年患者中不常见.
- 了解这些复杂病例的结果和成功预测因素对于改善患者护理至关重要.
研究的目的:
- 描述了需要多次ECMO运行的成年患者的结果.
- 在这个患者群体中确定与生存和并发症相关的因素.
主要方法:
- 在单个四级护理中心接受多次ECMO运行 (两次或三次) 的成年患者 (≥18岁) 的回顾性图表审查.
- 分析包括ECMO的指示,管策略,以及医院出院生存率和1年.
主要成果:
- 在451名被审查的患者中,46名 (10.1%) 接受了多次ECMO运行,主要是心脏切除术后心脏性休克 (72%).
- 90天/出院的存活率为21.7%,1年或以上的存活率为19.5%.
- 预测不良结果的因素包括第一个ECMO运行期间的急性功能衰竭,心脏切除术后的心脏性休克,右心室缩功能障碍和40岁以上的年龄.
结论:
- 急性功能衰竭,心脏切除术后心脏性休克,40岁以上,以及先前存在的右心室缩功能障碍与多次ECMO运行后的生存率差有关.
- 患有先天性心脏病的年轻患者 (<35岁) 可能是多次ECMO支持的合适候选人.
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