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在急性A型大动脉剖析修复后体外膜氧化:系统性审查和元分析
Nikolaos A Papakonstantinou1, Constantine N Antonopoulos2
1From the 2nd Cardiac Surgery Department, Onassis Cardiac Surgery Center, Athens, Greece.
概括
心脏手术后体外膜氧化 (ECMO) 在急性A型大动脉解剖 (ATAAD) 患者中显示出高死亡率和并发症. 需要进一步的研究来确定可能从这一关键干预中受益的患者.
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
- 医疗技术 医疗技术 医学技术
背景情况:
- 急性A型大动脉解剖 (ATAAD) 是一个关键的心血管紧急情况.
- 心脏手术后静脉动脉外体膜氧化 (VA-ECMO) 的使用已被确立为心脏性休克,但其在ATAAD中的作用仍在争论中.
研究的目的:
- 为了评估心脏切除术后ECMO在ATAAD修复后的疗效和结果.
- 分析需要ECMO的ATAAD患者的并发症率和存活率.
主要方法:
- 进行了对9项回顾性研究的元分析.
- 分析了接受ATAAD修复和随后ECMO支持的318名患者的数据.
主要成果:
- 整体住院死亡率高达72.4%.
- 在48.3%的患者中,ECMO成功奶,但并非所有患者都存活了下来.
- 观察到急性损伤 (60.5%),神经并发症 (24.4%),四肢缺血 (7.6%) 和出血再手术 (29.2%) 的高率.
结论:
- 尽管死亡率和并发症率很高,但在ATAAD修复后进行心脏切除术后的ECMO可能是特定患者的可行选择.
- 进一步的多中心研究至关重要,以确定在ATAAD中有利于ECMO使用的患者选择标准.
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