肝硬化中的毒性体外膜氧化结果:体外生命支持组织注册研究
Jonah Rubin1,2,3, Sophia Zhao1, Eric Przybyszewski4
1From the Division of Pulmonary & Critical Care Medicine, Massachusetts General Hospital, Boston, Massachusetts.
概括
经过毒性体外膜氧化 (VV ECMO) 的肝硬化患者的生存率较低. 然而,结果与其他公认的适应症相比,表明可以考虑VV ECMO.
科学领域:
- 关键护理医学 关键护理医学
- 移植 移植 移植 移植
- 肝病学 肝病学是一种肝病学.
背景情况:
- 肝硬化以前是毒性体外膜氧化 (VV ECMO) 的绝对禁忌.
- 对于肝硬化患者的VV ECMO结局存在有限的数据,影响候选决策.
- 最近的指导方针变化取消了肝硬化作为绝对的禁忌.
研究的目的:
- 在肝硬化患者中描述VV ECMO结果.
- 将结果与倾向匹配的队列进行比较.
- 为了确定这一群体的生存预测因素.
主要方法:
- 追溯查询体外生命支持组织 (ELSO) 登记册.
- 包括接受VV ECMO (2014年1月至2024年8月) 的肝硬化患者.
- 倾向匹配的队列分析和生存预测指标的回归.
主要成果:
- 72名肝硬化患者接受了VV ECMO;28%的患者存活到出院,而匹配队列中的44%.
- 两组之间并发症率或支持持续时间没有显著差异.
- 肝硬化和复杂肝硬化患者之间的生存率和并发症率相似.
- 没有确定可靠的死亡率预测因素.
结论:
- 肝硬化患者的VV ECMO结局比一般的VV ECMO患者要差,但与其他公认的指示相比,如体外心肺复苏 (ECPR).
- 这些发现可以为考虑为肝硬化患者提供VV ECMO的中心提供信息.
- 需要进一步的数据来完善理解和管理.
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