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严重呼吸衰竭患者行静脉-静脉体外膜肺氧合后静脉血栓形成的发生率。

Prevalence of Venous Thrombosis Following Venovenous Extracorporeal Membrane Oxygenation in Patients With Severe Respiratory Failure.

机构信息

Department of Critical Care, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom.

出版信息

Crit Care Med. 2015 Dec;43(12):e581-4. doi: 10.1097/CCM.0000000000001277.

Abstract

OBJECTIVES

Venovenous extracorporeal membrane oxygenation for patients with severe respiratory failure is increasingly common. There has been a significant change in the population, technology, and approach used for venovenous extracorporeal membrane oxygenation over the last 10 years. The objective of this study is to describe the prevalence of postdecannulation deep vein thrombosis in the cannulated vessel in adults who have received venovenous extracorporeal membrane oxygenation for severe respiratory failure.

DESIGN

A single-center, retrospective, observational cohort, electronic note review study.

SETTING

Tertiary referral university teaching hospital.

PATIENTS

Patients commenced on venovenous extracorporeal membrane oxygenation for severe respiratory failure.

INTERVENTIONS

None.

MEASUREMENTS AND MAIN RESULTS

We identified 103 patients commenced on extracorporeal membrane oxygenation with 81 survivors from December 2011 to February 2014. We performed postdecannulation venous Doppler ultrasound in 88.9% of extracorporeal membrane oxygenation survivors. The prevalence of deep vein thrombosis in the cannulated vessel following extracorporeal membrane oxygenation is 8.1/1,000 cannula days in patients who were screened.

CONCLUSIONS

The prevalence of deep vein thrombosis following decannulation from extracorporeal membrane oxygenation for severe respiratory failure is clinically significant, and routine venous Doppler ultrasound following decannulation is warranted in this population.

摘要

目的

对于患有严重呼吸衰竭的患者,静脉-静脉体外膜肺氧合的应用越来越普遍。在过去的 10 年中,静脉-静脉体外膜肺氧合的人群、技术和方法发生了重大变化。本研究的目的是描述接受静脉-静脉体外膜肺氧合治疗严重呼吸衰竭的成人在拔管后,在插管血管中深静脉血栓形成的发生率。

设计

单中心、回顾性、观察性队列、电子病历回顾研究。

地点

三级转诊大学教学医院。

患者

因严重呼吸衰竭而开始静脉-静脉体外膜肺氧合的患者。

干预措施

无。

测量和主要结果

我们确定了 2011 年 12 月至 2014 年 2 月期间接受体外膜肺氧合治疗的 103 名患者,其中 81 名患者存活。我们对 88.9%的体外膜肺氧合存活患者进行了拔管后静脉多普勒超声检查。在接受筛查的患者中,体外膜肺氧合拔管后插管血管中深静脉血栓形成的发生率为每 1000 个插管日 8.1 例。

结论

严重呼吸衰竭患者体外膜肺氧合拔管后深静脉血栓形成的发生率具有临床意义,该人群拔管后常规进行静脉多普勒超声检查是合理的。

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