比较接受静脉-动脉体外膜肺氧合治疗的成人和儿童暴发性心肌炎患者的存活率预测因素。

IF 1.7 Q2 MEDICINE, GENERAL & INTERNAL
Annals of Medicine and Surgery Pub Date : 2024-10-16 eCollection Date: 2024-12-01 DOI:10.1097/MS9.0000000000002636
Yomna E Dean, Mohamed Doma, Ahson Afzal, Sameh Samir Elawady, Rafeek W Elmezayen, Bdoor Ahmed A Bamousa, Naila Iqbal, Muluken Zeleke Megiso, Sriharsha Kodurum, Adham Ramadan, Mahmoud El Bahaie, Ahmed Magdi, Fatima Afzal, Helmy Badr, Basant Katamesh, Dina Ismail, Yasser Etman, Yusef Hazimeh, Edward Darling, Hani Aiash
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引用次数: 0

摘要

背景:暴发性心肌炎(FM)是一种潜在的危及生命的疾病,需要紧急护理。作者的研究旨在探讨使用静脉-动脉体外膜氧合(VA-ECMO)支持治疗成人和儿童FM患者的临床结果和生存预测因素,以分析两种人群之间的差异。方法:检索PubMed、Scopus、Web of Science和Cochrane数据库,检索有关VA-ECMO对诊断为暴发性心肌炎患者疗效的研究。采用R 4.2.2版本进行统计分析。结果:43项研究纳入我们的分析,共1268例患者。成人和儿科患者的生存率分别为65%和71%。在VA-ECMO前没有心脏骤停的患者在这两种人群中都有更好的生存机会;成人(OR 0.44;页= 0.006)。成年患者年龄越小生存率越高(MD= -8.81;结论:在暴发性心肌炎患者中使用VA-ECMO可显著改善生存结果,两组患者的预后均随着年龄的增加而改善,且两组患者均无心脏骤停史。
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 predictors of survival among fulminant myocarditis patients undergoing veno-arterial extracorporeal membrane oxygenation in the adult and pediatric populations.

Background: Fulminant myocarditis (FM) is a potentially life-threatening disease that requires emergency care. The authors' study aims to explore clinical outcomes and predictors of survival when using veno-arterial extracorporeal membrane oxygenation (VA-ECMO) support for the treatment of FM in adult and pediatric patients to analyze differences between both populations.

Methods: PubMed, Scopus, Web of Science, and Cochrane databases were searched for studies reporting the effect of VA-ECMO on patients diagnosed with fulminant myocarditis. Statistical analysis was performed using R version 4.2.2.

Results: Forty-three studies were included in our analysis with a total of 1268 patients. Survival rates were 65% and 71% among adult and pediatric patients, respectively. Patients who didn't suffer from cardiac arrest prior to VA-ECMO had better chances of survival in both populations; adults (OR 0.44; P<0.01) and pediatric (OR = 0.32; P= 0.006). Younger age was associated with higher survival among the adults (MD= -8.81; P<0.01). Additionally, pre-ECMO LVEF was higher among survivors in the pediatric group (MD= 8.23; P<0.01). Furthermore, no significant association was detected between sex, VA-ECMO duration, systolic blood pressure, lactate levels, and survival rates among both groups.

Conclusion: Using VA-ECMO in patients with fulminant myocarditis can significantly improve survival outcomes, with improved prognosis observed with younger age among adults and absence of prior history of cardiac arrest in both groups.

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Annals of Medicine and Surgery
Annals of Medicine and Surgery MEDICINE, GENERAL & INTERNAL-
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