Ann Intensive Care:阜外医院超百例ECMO救治心原性休克经验:同时应用IABP可降低院内死亡率 ​

2020-01-26 xujing 中国循环杂志

阜外医院学者分析了应用静-动脉体外膜氧合(VA-ECMO)救治的152例心原性休克患者的临床资料,发现IABP与ECMO同时启用能使院内死亡率降低62%,减少并发症。

阜外医院学者分析了应用静-动脉体外膜氧合(VA-ECMO)救治的152例心原性休克患者的临床资料,发现IABP与ECMO同时启用能使院内死亡率降低62%,减少并发症。
 
本组患者的平均年龄(49.5±14.1)岁,男性占73.7%。主要手术方式为心脏移植(32.2%)、冠状动脉旁路移植(17%)和瓣膜手术(11.8%)。
 
本组患者中,32.2%的患者实施了主动脉内球囊反搏(IABP)与ECMO同时启用,18.4%的患者实施了续贯启动IABP与ECMO。
 
ECMO脱机率为56.6%,住院死亡率为52.0%。
 
与死亡患者相比,存活者的高血压、ECMO开始前的二次开胸、心脏骤停/心室颤动、床边植入ECMO的比例更低,而移植手术,ECMO同时启用IABP的比例较高。
 
多因素logistic回归分析显示,IABP与ECMO同时启用能使院内死亡率降低62%。
 
此外,对于同时启用IABP与ECMO的患者,他们对持续性肾脏替代治疗的需求较少,神经并发症较少,但血栓并发症较多。
 

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    2020-08-09 wleon8895
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    2020-10-06 zhangbaojun
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