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接受体外膜肺氧合治疗的囊性纤维化患者的生存情况:体外生命支持组织登记处分析

Survival of patients with cystic fibrosis on ECMO: analysis of the Extracorporeal Life Support Organization Registry.

作者信息

Hayes Don, Kopp Benjamin T, Preston Thomas J, Kirkby Stephen, Tobias Joseph D, Papadimos Thomas J, Whitson Bryan A

机构信息

Department of Pediatrics, The Ohio State University College of Medicine, Section of Pulmonary Medicine, Nationwide Children's Hospital Columbus, OH, USA.

Department of Cardiovascular Perfusion, Heart Center, Nationwide Children's Hospital Columbus, OH, USA.

出版信息

Int J Clin Exp Med. 2014 May 15;7(5):1370-2. eCollection 2014.

Abstract

Progressive respiratory failure is a common cause of death in patients with cystic fibrosis (CF). Although this may be related to the disease process itself, acute infectious problems may lead to respiratory failure requiring mechanical ventilation. Given the progressive nature of the disorder, some have suggested that the use of extracorporeal membrane oxygenation (ECMO) is contraindicated. The current study retrospectively reviewed the Extracorporeal Life Support Organization (ELSO) Registry to evaluate the outcomes following the use of ECMO in patients with CF. A total of 73 ECMO runs were identified in CF patients. There were 33 who received VV ECMO, 32 on VA ECMO, and 8 who received combined VA and VA ECMO. The overall survival rate for the cohort was 52% (38 of 73 patients). There was no difference in survival when comparing VA and VV ECMO. We noted an increasing trend for VV ECMO for this patient population over this time period. These data further support the need for a prospective study to evaluate outcomes following ECMO in this population with standardization of care across multiple centers.

摘要

进行性呼吸衰竭是囊性纤维化(CF)患者常见的死亡原因。虽然这可能与疾病本身的进程有关,但急性感染问题可能导致呼吸衰竭而需要机械通气。鉴于该疾病的进行性本质,一些人认为使用体外膜肺氧合(ECMO)是禁忌的。当前研究回顾性分析了体外生命支持组织(ELSO)登记处的数据,以评估CF患者使用ECMO后的结局。在CF患者中总共确定了73次ECMO治疗。其中33人接受了静脉-静脉(VV)ECMO,32人接受了静脉-动脉(VA)ECMO,8人接受了VA和VV联合ECMO。该队列的总体生存率为52%(73例患者中的38例)。比较VA和VV ECMO时,生存率没有差异。我们注意到在此时间段内该患者群体使用VV ECMO有增加的趋势。这些数据进一步支持需要进行前瞻性研究,以评估该人群使用ECMO后的结局,并在多个中心实现护理标准化。

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