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体外膜肺氧合治疗患者中计算机断层扫描的管理效益和安全性:单中心经验。

Management benefits and safety of computed tomography in patients undergoing extracorporeal membrane oxygenation therapy: experience of a single centre.

机构信息

Department of Radiology, University Hospitals of Leicester, UK.

出版信息

Clin Radiol. 2010 Nov;65(11):881-6. doi: 10.1016/j.crad.2010.05.007. Epub 2010 Sep 6.

Abstract

AIM

To evaluate the benefits and logistical safety of computed tomography (CT) imaging in patients undergoing extracorporeal membrane oxygenation (ECMO) therapy in a single institution.

MATERIALS AND METHODS

Over a period of 25 months, 134 patients (80 neonates, 19 children, and 35 adults) underwent ECMO therapy at this institution. The imaging of these patients was reviewed to identify patients who had undergone CT imaging whilst on ECMO. Patient notes were retrospectively reviewed. CT findings and subsequent decisions were analysed to assess the benefit of CT imaging. Complications arising due to the logistics of performing the scan were analysed to assess the safety of performing CT in ECMO patients.

RESULTS

Of 134 patients, 14 (10%) had a total of 15 CT examinations whilst undergoing ECMO therapy. Indications for CT included new neurology, increased respiratory demand, and increasing requirement for high ECMO flows. There were no major complications and two minor complications associated with the logistics of performing a CT examination on an ECMO patient. Significant findings resulted from 73.3% (11/15) of the CT examinations, and in all 15 examinations information was provided that was used in making further management decisions, including, in some cases, withdrawal of ECMO therapy.

CONCLUSION

With an experienced team, CT imaging of patients on ECMO can be performed safely. CT provides valuable information for subsequent management of patients undergoing ECMO therapy.

摘要

目的

评估在单一机构中对接受体外膜肺氧合(ECMO)治疗的患者进行计算机断层扫描(CT)成像的益处和后勤安全性。

材料和方法

在 25 个月的时间内,本机构对 134 名患者(80 名新生儿、19 名儿童和 35 名成人)进行了 ECMO 治疗。对这些患者的影像学进行了回顾性分析,以确定在接受 ECMO 治疗期间接受过 CT 成像的患者。回顾性分析患者病历。分析 CT 结果和随后的决策,以评估 CT 成像的益处。分析因扫描的后勤工作而产生的并发症,以评估在 ECMO 患者中进行 CT 检查的安全性。

结果

在 134 名患者中,有 14 名(10%)患者在接受 ECMO 治疗期间共进行了 15 次 CT 检查。CT 检查的适应证包括新出现的神经系统症状、呼吸需求增加和 ECMO 流量增加。没有与在 ECMO 患者中进行 CT 检查的后勤工作相关的主要并发症,只有 2 例轻微并发症。73.3%(11/15)的 CT 检查有显著发现,在所有 15 次检查中,都提供了有助于进一步管理决策的信息,包括在某些情况下停止 ECMO 治疗。

结论

在有经验的团队的支持下,对接受 ECMO 治疗的患者进行 CT 成像可以安全进行。CT 检查可为接受 ECMO 治疗的患者的后续管理提供有价值的信息。

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