Characteristics and Outcomes of Veno-Arterial Extracorporeal Membrane Oxygenation in Accidental Hypothermia: A Multicenter Study in Japan.

IF 0.8 4区 医学 Q4 CRITICAL CARE MEDICINE
Tadaharu Shiozumi, Yuki Miyamoto, Sachiko Morita, Naoki Ehara, Nobuhiro Miyamae, Yohei Okada, Takaaki Jo, Yasuyuki Sumida, Nobunaga Okada, Makoto Watanabe, Masahiro Nozawa, Ayumu Tsuruoka, Yoshihiro Fujimoto, Yoshiki Okumura, Tetsuhisa Kitamura, Bon Ohta, Tasuku Matsuyama
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引用次数: 0

Abstract

Despite growing evidence supporting the efficacy of veno-arterial extracorporeal membrane oxygenation (VA-ECMO) for accidental hypothermia (AH), few studies have assessed its real-world application. We aimed to describe the use and outcomes of VA-ECMO in AH patients using data from a multicenter registry. This retrospective study included adult AH patients from the Japanese accidental hypothermia network registry (J-Point registry) between April 2011 and March 2016. We analyzed patient characteristics, in-hospital data, VA-ECMO indications, and clinical outcomes for those who received VA-ECMO. Of the 537 patients in this registry, 22 received VA-ECMO, with a median age of 80 years. Severe AH was present in 18 patients, and 10 experienced cardiac arrest (CA) on hospital arrival. VA-ECMO was indicated for CA on hospital arrival (10 patients), CA after hospital arrival (5), hemodynamic instability (5), and severe hypothermia (1), with 1 case having an unclear indication. Rewarming was successful in 18 patients, and 9 survived. Survival was higher among those with CA on hospital arrival (5/10) compared with those who developed CA after hospital arrival (1/5). This study highlights the clinical application and outcomes of VA-ECMO for AH patients using multicenter registry data. Among the 22 patients who received VA-ECMO, 9 survived. Patients with CA on hospital arrival showed better survival compared with those who developed CA after arrival, emphasizing the importance of timely VA-ECMO initiation. Further research is warranted to refine patient selection, optimize initiation timing, and evaluate long-term outcomes.

意外低温中静脉-动脉体外膜氧合的特点和结果:日本的一项多中心研究。
尽管越来越多的证据支持静脉-动脉体外膜氧合(VA-ECMO)治疗意外低温症(AH)的疗效,但很少有研究评估其在现实世界中的应用。我们的目的是利用多中心注册的数据描述VA-ECMO在AH患者中的应用和结果。这项回顾性研究纳入了2011年4月至2016年3月期间来自日本意外低温网络登记处(J-Point登记处)的成年AH患者。我们分析了患者特征、住院数据、VA-ECMO适应症和接受VA-ECMO患者的临床结果。在537例患者中,22例接受了VA-ECMO,中位年龄为80岁。18例患者出现严重AH, 10例在到达医院时出现心脏骤停(CA)。VA-ECMO适用于入院时CA(10例)、入院后CA(5例)、血流动力学不稳定(5例)和严重低温症(1例),其中1例适应症不明确。18例患者成功复温,9例存活。到达医院时患有CA的患者的生存率(5/10)高于到达医院后发生CA的患者(1/5)。本研究利用多中心注册数据强调了VA-ECMO在AH患者中的临床应用和结果。在22例接受VA-ECMO的患者中,9例存活。与到达医院后发生CA的患者相比,到达医院时发生CA的患者生存率更高,这强调了及时启动VA-ECMO的重要性。进一步的研究是必要的,以完善患者选择,优化起始时间,并评估长期结果。
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
CiteScore
2.50
自引率
8.30%
发文量
35
期刊介绍: Therapeutic Hypothermia and Temperature Management is the first and only journal to cover all aspects of hypothermia and temperature considerations relevant to this exciting field, including its application in cardiac arrest, spinal cord and traumatic brain injury, stroke, burns, and much more. The Journal provides a strong multidisciplinary forum to ensure that research advances are well disseminated, and that therapeutic hypothermia is well understood and used effectively to enhance patient outcomes. Novel findings from translational preclinical investigations as well as clinical studies and trials are featured in original articles, state-of-the-art review articles, protocols and best practices. Therapeutic Hypothermia and Temperature Management coverage includes: Temperature mechanisms and cooling strategies Protocols, risk factors, and drug interventions Intraoperative considerations Post-resuscitation cooling ICU management.
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