体外膜氧合对磷酸铝中毒死亡率的影响：系统回顾和荟萃分析。

IF 1.5 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Journal of Research in Medical Sciences Pub Date : 2024-10-24 eCollection Date: 2024-01-01 DOI:10.4103/jrms.jrms_123_24

Mohammad Moshiri, Gholamali Dorooshi, Leila Etemad, Awat Feizi, Alireza Rahimi, Farzad Gheshlaghi, Arman Otroshi, Shiva Samsamshariat, Nastaran Eizadi-Mood

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引用次数: 0

摘要

背景：磷酸铝（ALP）中毒继发于心源性休克的死亡率（MR）很高。最近，体外膜氧合（ECMO）在这一问题上取得了成功的结果。我们进行了系统回顾和荟萃分析，比较了接受ECMO和常规治疗的ALP中毒患者的MR。材料和方法：根据PRISMA方案对ECMO治疗应用研究或常规治疗应用研究进行两个平行数据库的综述。所有语言的研究和英文会议摘要均被纳入ECMO治疗应用研究。只有报道MR的英语人类观察性研究被纳入常规治疗应用研究。对所有ETAS病例报告进行总结，并作为新生成的横断面研究（NGCSS）纳入meta分析。结果：167和1043份记录中，选择了17份病例报告（24例），3份横断面研究和9份常规治疗应用研究。在meta分析中，NGCSS作为第四项横断面ECMO治疗应用研究。ecmo治疗病例的总体MR（23%[95%可信区间（CI）： 7%-39%]）显著低于常规治疗病例(60% [95% CI: 39%-63%]；P < 0.001)。在ECMO治疗的病例中，存活和未存活病例的年龄、血pH值、ALP剂量、住院时间、ECMO滞后时间和ECMO持续时间加权平均差异（WMD）无统计学意义。然而，心脏射血分数的WMD (4.6%；95% ci: 2.76%-6.39%；P < 0.0001)，暴露于住院滞后时间(-2.05；95% CI: -4.05-0.14 h；P = 0.06)，住院时间(16；95% CI: 12.0-20.5天；P < 0.0001)。结论：ECMO可降低alp中毒患者的MR；然而，这是一个高度侵入性和复杂的过程。

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Effect of extracorporeal membrane oxygenation on mortality rate of aluminum phosphate poisoning: A systematic review and meta-analysis.

Background: Aluminum phosphate (ALP) poisoning has a high mortality rate (MR) secondary to cardiogenic shock. Recently, extracorporeal membrane oxygenation (ECMO) showed a successful result in this issue. We conducted a systematic review and meta-analysis to compare the MR of patients with ALP poisoning who underwent ECMO versus those with conventional treatment.

Materials and methods: Two parallel databases' reviews were done to find the ECMO treatment-applied studies or conventional treatment-applied studies according to the PRISMA protocol. All studies in any languages and English conference abstracts were included for ECMO treatment-applied studies. Only English-language human observational studies, which reported MR, were included in conventional treatment-applied studies. All ETAS case reports were summarized and used as a newly generated cross-sectional study (NGCSS) for inclusion in the meta-analysis.

Results: Out of 167 and 1043 records, 17 case reports (24 cases), 3 cross-sectional studies, and 9 conventional treatment-applied studies were selected. In meta-analysis NGCSS applied as the fourth cross-sectional ECMO treatment-applied studies. The overall MR of ECMO-treated cases (23% [95% confidence interval (CI): 7%-39%]) was significantly less than conventionally treated cases (60% [95% CI: 39%-63%]; P < 0.001). In ECMO-treated cases, the weighted mean difference (WMD) for age, blood pH, ALP dose, hospitalization, ECMO lag time, and ECMO duration were not statistically significant between survived and nonsurvived cases. However, WMD of cardiac ejection fraction (4.6%; 95% CI: 2.76%-6.39%; P < 0.0001), exposure to hospitalization lag time (-2.05; 95% CI: -4.05-0.14 h; P = 0.06), and length of hospital stay (16; 95% CI: 12.0-20.5 days; P < 0.0001) between survived and nonsurvived ETC were significant.

Conclusion: ECMO reduced the MR of ALP-poisoned patients; however, it is a highly invasive and complicated procedure.

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来源期刊

Journal of Research in Medical Sciences MEDICINE, GENERAL & INTERNAL-

CiteScore

2.60

自引率

6.20%

发文量

审稿时长

3-6 weeks

期刊介绍： Journal of Research in Medical Sciences, a publication of Isfahan University of Medical Sciences, is a peer-reviewed online continuous journal with print on demand compilation of issues published. The journal’s full text is available online at http://www.jmsjournal.net. The journal allows free access (Open Access) to its contents and permits authors to self-archive final accepted version of the articles on any OAI-compliant institutional / subject-based repository.