Influence of minimal invasive extracorporeal circuits on dialysis dependent patients undergoing cardiac surgery.

IF 1.1 4区医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS

Perfusion-Uk Pub Date : 2024-11-01 Epub Date: 2023-11-17 DOI:10.1177/02676591231216794

Thai Duy Nguyen, Mohammed Morjan, Khaldoun Ali, Ingo Breitenbach, Wolfgang Harringer, Aschraf El-Essawi

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Abstract

Introduction: Cardiac surgery in patients on chronic renal dialysis is associated with significant morbidity and mortality. Minimally invasive extracorporeal circuits (MiECC) have shown a positive impact on patient outcome in different high-risk populations. This retrospective study compares the outcome of these high-risk patients undergoing heart surgery either with a MiECC or a conventional extracorporeal circulation (CECC).

Methods: This is a single-center experience including 131 consecutive dialysis dependent patients undergoing cardiac surgery between January 2006 and December 2016. A propensity score matching was employed leaving 30 matched cases in each group.

Results: After propensity score matching the 30-day mortality was significantly lower in the MiECC group (n = 3 (10%) vs n = 10 (33%) in the CECC group, p = .028). Further, intraoperative transfused units of packed red blood cells were lower in the MiECC group (1.4 ± 1.8 units vs 2.8 ± 1.7, p < .001).

Conclusions: There are evident advantages to using MiECC in dialysis dependent patients, especially regarding mortality. These findings necessitate additional research in MiECC usage in high-risk populations.

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微创体外循环对心脏手术依赖透析患者的影响。

慢性肾透析患者的心脏手术与显著的发病率和死亡率相关。微创体外电路(MiECC)对不同高危人群的患者预后有积极影响。这项回顾性研究比较了这些高危患者接受心脏手术的结果，无论是MiECC还是传统的体外循环(CECC)。方法:这是一项单中心研究，包括2006年1月至2016年12月期间接受心脏手术的131例连续透析依赖患者。采用倾向评分匹配，每组留下30个匹配病例。结果:倾向评分与30天死亡率匹配后，MiECC组的死亡率显著降低(n = 3(10%)比CECC组的n = 10 (33%)， p = 0.028)。此外，MiECC组术中输血的填充红细胞单位较低(1.4±1.8单位vs 2.8±1.7单位，p < 0.001)。结论:在透析依赖患者中使用MiECC有明显的优势，特别是在死亡率方面。这些发现需要对高危人群使用MiECC进行进一步的研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Perfusion-Uk 医学-外周血管病

CiteScore

3.00

自引率

8.30%

发文量

203

审稿时长

6-12 weeks

期刊介绍： Perfusion is an ISI-ranked, peer-reviewed scholarly journal, which provides current information on all aspects of perfusion, oxygenation and biocompatibility and their use in modern cardiac surgery. The journal is at the forefront of international research and development and presents an appropriately multidisciplinary approach to perfusion science.