Comparison of Conventional Methods with Pump-Controlled Retrograde Trial off for Weaning Adults with Cardiogenic Shock from Veno-Arterial Extracorporeal Membrane Oxygenation.

Q4 Medicine
J. Jo, Woo Sung Jang, N. Park, Y. Kim, Jae Bum Kim, K. Song
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Abstract

Background Pump-controlled retrograde trial off (PCRTO) is a safe, simple, and reversible method for weaning patients from veno-arterial extracorporeal membrane oxygenation (VA-ECMO). However, few studies have compared PCRTO to conventional weaning methods. This retrospective study aimed to compare PCRTO to non-PCRTO methods. Methods This study included patients who were weaned from VA-ECMO from January 2016 to December 2022 at our medical center. Demographic data, ECMO management, ECMO complications, survival to discharge, and cardiogenic shock after VA-ECMO weaning were compared between the 2 groups. Results Seventy patients who were weaned from VA-ECMO using PCRTO and 85 patients who were weaned with conventional methods were compared. Patient characteristics were not significantly different between the 2 groups. The rate of survival to discharge was significantly higher in the PCRTO group than in the non-PCRTO group (90% vs. 72%, p=0.01). The rates of freedom from all-cause mortality at 10, 30, and 50 days after weaning from ECMO were 75%, 55%, and 35% in the non-PCRTO group and 62%, 60%, and 58% in the PCRTO group, respectively (p=0.1). The incidence of cardiogenic shock after weaning from VA-ECMO was significantly higher in the non-PCRTO group (16% vs. 5%, p=0.04). In logistic regression analysis, PCRTO was a significant factor for survival to discharge (odds ratio, 2.42; 95% confidence interval, 1.29-5.28; p=0.02). Conclusion Compared to conventional methods, PCRTO is a feasible and reversible method, and it serves as a useful predictor of successful VA-ECMO weaning through a preload stress test.
比较传统方法与泵控制逆行试验关闭法,为患有心源性休克的成人进行静脉-动脉体外膜氧合疗程断流。
背景泵控逆行脱机(PCRTO)是一种安全、简单、可逆的静脉-动脉体外膜氧合(VA-ECMO)患者断流方法。然而,很少有研究将 PCRTO 与传统断流方法进行比较。本回顾性研究旨在比较 PCRTO 和非 PCRTO 方法。方法本研究纳入了 2016 年 1 月至 2022 年 12 月在本医疗中心从 VA-ECMO 断流的患者。比较了两组患者的人口统计学数据、ECMO管理、ECMO并发症、出院生存率以及VA-ECMO断流后的心源性休克。两组患者的特征无明显差异。PCRTO 组的出院存活率明显高于非 PCRTO 组(90% 对 72%,P=0.01)。在 ECMO 断流后 10 天、30 天和 50 天,非 PCRTO 组的全因死亡率分别为 75%、55% 和 35%,而 PCRTO 组分别为 62%、60% 和 58%(P=0.1)。从 VA-ECMO 断流后,非 PCRTO 组的心源性休克发生率明显更高(16% 对 5%,P=0.04)。结论与传统方法相比,PCRTO 是一种可行且可逆的方法,通过前负荷压力测试,PCRTO 是预测 VA-ECMO 成功断流的有效指标。
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
Journal of Chest Surgery
Journal of Chest Surgery Medicine-Surgery
CiteScore
0.80
自引率
0.00%
发文量
76
审稿时长
7 weeks
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