静脉体外膜氧合患者断流策略的比较:一项探索性回顾研究

IF 3.1 3区 医学 Q2 ENGINEERING, BIOMEDICAL
ASAIO Journal Pub Date : 2024-11-01 Epub Date: 2024-05-07 DOI:10.1097/MAT.0000000000002223
Bernhard Nagler, Nina Buchtele, Alexander Hermann, Oliver Robak, Andja Bojic, Peter Schellongowski, Thomas Staudinger
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引用次数: 0

摘要

静脉体外膜氧合(VV ECMO)有助于减少急性呼吸衰竭患者的机械通气(MV)支持。与越来越多的证据表明开始使用 VV ECMO 相反,VV ECMO 断流与 MV 断流相互作用的最佳时机尚未确定。在这项回顾性研究中,47 名在 2013 年至 2021 年期间接受 VV ECMO 且在 ECMO 停止后存活≥1 天的患者根据其在 ECMO 拔除前的 MV 状态进行了分类:28 名患者被分为 "辅助 MV/自主呼吸期间 ECMO 断流 "组,19 名患者被分为 "控制 MV 期间 ECMO 断流 "组。辅助 MV/自主呼吸 "组的体外膜氧合持续时间更长(17 [四分位距(IQR)= 11-35] 对 6 [5-11] 天,P < 0.001)。这些患者在 ECMO 启动后入住重症监护室(ICU)的时间更长(48 [29-66] 天 vs 31 [15-40] 天,p = 0.01)。在 ECMO 启动后的 MV 持续时间(30 [19-45] 天 vs. 19 [12-30] 天,p = 0.06)和进一步的 ICU 存活率(86% vs. 89%,p ≥ 0.9)方面没有发现明显差异。辅助 MV/ 自主呼吸 "组中出现机械 ECMO 并发症的患者有增多趋势(57% 对 32%,p = 0.08)。因此,我们的研究结果表明,在控制 MV 期间及早进行 ECMO 断流可能有益。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Comparison of Weaning Strategies in Patients Receiving Venovenous Extracorporeal Membrane Oxygenation: An Exploratory Retrospective Study.

Venovenous extracorporeal membrane oxygenation (VV ECMO) facilitates the reduction of mechanical ventilation (MV) support in acute respiratory failure. Contrary to increasing evidence regarding its initiation, the optimal timing of VV ECMO weaning in interaction with MV weaning is undetermined. In this retrospective study, 47 patients who received VV ECMO between 2013 and 2021 and survived ≥1 day after ECMO cessation were divided according to their MV status before ECMO removal: 28 patients were classified into an "ECMO weaning during assisted MV/spontaneous breathing" group and 19 into an "ECMO weaning during controlled MV" group. Extracorporeal membrane oxygenation duration was longer in the "assisted MV/spontaneous breathing" group (17 [Interquartile range (IQR) = 11-35] vs. 6 [5-11] days, p < 0.001). These patients had a longer intensive care unit (ICU) stay after ECMO start (48 [29-66] vs. 31 [15-40] days, p = 0.01). No significant differences were found for MV duration after ECMO start (30 [19-45] vs. 19 [12-30] days, p = 0.06) and further ICU survival (86% vs. 89%, p ≥ 0.9). There was a trend toward more patients with mechanical ECMO complications in the "assisted MV/spontaneous breathing" group (57% vs. 32%, p = 0.08). Thus, our results suggest a possible benefit of early ECMO weaning during controlled MV.

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来源期刊
ASAIO Journal
ASAIO Journal 医学-工程:生物医学
CiteScore
6.60
自引率
7.10%
发文量
651
审稿时长
4-8 weeks
期刊介绍: ASAIO Journal is in the forefront of artificial organ research and development. On the cutting edge of innovative technology, it features peer-reviewed articles of the highest quality that describe research, development, the most recent advances in the design of artificial organ devices and findings from initial testing. Bimonthly, the ASAIO Journal features state-of-the-art investigations, laboratory and clinical trials, and discussions and opinions from experts around the world. The official publication of the American Society for Artificial Internal Organs.
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