体外膜肺氧合在创伤中的应用:日本全国创伤登记处的回顾性分析。

IF 2.3 3区 医学 Q1 EMERGENCY MEDICINE
Tomohiro Akutsu, Akira Endo, Ryo Yamamoto, Kazuma Yamakawa, Keisuke Suzuki, Hiromasa Hoshi, Yasuhiro Otomo, Koji Morishita
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引用次数: 0

摘要

背景:体外膜肺氧合(ECMO)可提供临时循环支持和重要器官氧合,在某些创伤病例中可作为一种桥接疗法。我们的目的是利用日本全国创伤登记处的数据,展示接受静脉-动脉 ECMO(V-A ECMO)治疗的创伤患者的特征和预后:这项回顾性描述性研究分析了日本创伤数据库在 2019 年 1 月至 2021 年 12 月期间的数据。评估了严重创伤(损伤严重程度评分 [ISS] ≥ 9)并接受 V-A ECMO 治疗的患者:在 72 439 名严重创伤患者中,51 人接受了 V-A ECMO。16 名患者(31.3%)存活至出院。到达医院时,6 名幸存者(37.5%)和 15 名非幸存者(42.9%)出现心脏骤停。幸存者组和非幸存者组的 ISS 中位数分别为 25(范围为 25-39)和 25(范围为 17-33)。胸腔创伤是两组中最常见的创伤类型。在非幸存者组中,分别有 10 名(28.6%)、5 名(14.3%)和 4 名(11.4%)患者进行了开胸心肺复苏术、主动脉交叉钳夹术和主动脉血管内球囊闭塞复苏术。然而,幸存者组没有进行这些手术。幸存者组的外周血氧饱和度在入院前和入院时均较低:本研究结果表明,在一些具有挑战性的创伤病例中,V-A ECMO 具有潜在的益处。有必要开展进一步研究,评估 V-A ECMO 在创伤患者中的适应症。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Veno-arterial extracorporeal membrane oxygenation uses in trauma: a retrospective analysis of the Japanese nationwide trauma registry.

Background: Extracorporeal membrane oxygenation (ECMO) can provide temporary circulatory support and vital organ oxygenation and is potentially useful as a bridge therapy in some trauma cases. We aimed to demonstrate the characteristics and outcomes of patients with trauma treated with veno-arterial ECMO (V-A ECMO) using data from a Japanese nationwide trauma registry.

Methods: This retrospective descriptive study analyzed data from the Japan Trauma Data Bank between January 2019 and December 2021. Patients with severe trauma (injury severity score [ISS] ≥ 9) and treated using V-A ECMO were assessed.

Results: Among the 72,439 patients with severe trauma, 51 received V-A ECMO. Sixteen patients (31.3%) survived until hospital discharge. On hospital arrival, six (37.5%) survivors and 15 (42.9%) non-survivors experienced cardiac arrest. The median ISS for the survivor and non-survivor group was 25 (range, 25-39) and 25 (range, 17-33), respectively. Thoracic trauma was the most common type of trauma in both groups. In the non-survivor group, open-chest cardiopulmonary resuscitation, aortic cross-clamping, and resuscitative endovascular balloon occlusion of the aorta were performed in 10 (28.6%), 5 (14.3%), and 4 (11.4%) patients, respectively. However, these procedures were not performed in the survivor group. Peripheral oxygen saturation tended to be lower in the survivor group both before and upon arrival at the hospital.

Conclusions: The results of this study suggest the potential benefit of V-A ECMO in some challenging trauma cases. Further studies are warranted to assess the indications for V-A ECMO in patients with trauma.

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来源期刊
BMC Emergency Medicine
BMC Emergency Medicine Medicine-Emergency Medicine
CiteScore
3.50
自引率
8.00%
发文量
178
审稿时长
29 weeks
期刊介绍: BMC Emergency Medicine is an open access, peer-reviewed journal that considers articles on all urgent and emergency aspects of medicine, in both practice and basic research. In addition, the journal covers aspects of disaster medicine and medicine in special locations, such as conflict areas and military medicine, together with articles concerning healthcare services in the emergency departments.
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