Ann Thorac Surg:成人感染性休克患者接受体外膜氧合治疗的结果

2020-02-20 不详 网络

体外膜氧合(ECMO)已被证明对败血性休克儿童有益,而对成年人则无益处。我们描述了败血症性休克接受ECMO的成年人的临床结局。我们回顾性研究了从1/1 / 2009-12 / 31/2016开始在美国四级医疗中心进行插管时感染性休克的ECMO的静脉-动脉或静脉-静脉模式支持的成年人。主要结果是使用Kaplan-Meier生存估算值得出的出院生存率和生存时间。我们按模式,先前的心脏骤停和插管时间(入

体外膜氧合(ECMO)已被证明对败血性休克儿童有益,而对成年人则无益处。我们描述了败血症性休克接受ECMO的成年人的临床结局。

我们回顾性研究了从1/1 / 2009-12 / 31/2016开始在美国四级医疗中心进行插管时感染性休克的ECMO的静脉-动脉或静脉-静脉模式支持的成年人。主要结果是使用Kaplan-Meier生存估算值得出的出院生存率和生存时间。我们按模式,先前的心脏骤停和插管时间(入院重症监护室后<96和≥96小时)分析了生存率。次要结果是并发症和ECMO支持的天数,在重症监护室的住院时间以及住院天数。

结果显示,在这7年的时间里,在243名接受ECMO支持的患者中,有32名达到了败血性休克的标准,并且大多数有肺部感染源(72%)。最常见的支持方式是VV ECMO(65%),中位射血分数为51%。 ECMO的中位时间为5.8天(IQR 2.6,11.3)。出院生存率为32/13(41%),中位生存期为14.5天(5.2,23.7)。亚组(包括ECMO模式)的生存率在统计学上没有显著差异。医疗保健相关的感染很常见(25%)。

综上所述,与基于文献的其他败血性休克患者队列估计相比,我们接受ECMO的患者队列中位生存期相当。

原始出处:

Myers LC, Lee C, et al., Outcomes of adult patients with septic shock receiving extracorporeal membrane oxygenation therapy. Ann Thorac Surg. 2020 Feb 16. pii: S0003-4975(20)30203-4. doi: 10.1016/j.athoracsur.2019.12.075.

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