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急性ST段抬高型心肌梗死合并严重心源性休克患者体外膜肺氧合术后30天生存率的相关因素。

Associations with 30-day survival following extracorporeal membrane oxygenation in patients with acute ST segment elevation myocardial infarction and profound cardiogenic shock.

作者信息

Lee Wei-Chieh, Fang Chih-Yuan, Chen Huang-Chung, Chen Chien-Jen, Yang Cheng-Hsu, Hang Chi-Ling, Yip Hon-Kan, Fang Hsiu-Yu, Wu Chiung-Jen

机构信息

Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan, Taiwan, ROC.

Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan, Taiwan, ROC.

出版信息

Heart Lung. 2016 Nov-Dec;45(6):532-537. doi: 10.1016/j.hrtlng.2016.08.006. Epub 2016 Sep 3.

Abstract

BACKGROUND

Limited data are available regarding the role of percutaneous cardiopulmonary support for the treatment of ST segment elevation myocardial infarction (STEMI) with profound cardiogenic shock (CS). The aim of this study is to identify the determinant factors for survival of patients with STEMI who underwent extracorporeal membrane oxygenation (ECMO) support.

METHOD

From January 2005 to December 2013, 192 patients experienced STEMI with CS needed intra-aortic balloon pumping and support with vasoactive agents at our hospital. Among them, 51 patients experienced profound CS and needed ECMO support.

RESULTS

Higher body mass index (BMI) level, longer door-to-balloon time, higher serum blood urea nitrogen (BUN) level, and lower 24 h lactic acid clearance were associated with 30-day mortality post-ECMO.

CONCLUSIONS

Longer door-to-balloon time, higher BMI, higher serum BUN level, and poorer lactic acid clearance following ECMO placement for patients with STEMI and profound CS could predict 30-day clinical outcomes.

摘要

背景

关于经皮心肺支持在治疗伴有严重心源性休克(CS)的ST段抬高型心肌梗死(STEMI)中的作用,现有数据有限。本研究的目的是确定接受体外膜肺氧合(ECMO)支持的STEMI患者生存的决定因素。

方法

2005年1月至2013年12月,我院192例患有STEMI合并CS的患者需要主动脉内球囊反搏及血管活性药物支持。其中,51例患者出现严重CS并需要ECMO支持。

结果

较高的体重指数(BMI)水平、较长的门球时间、较高的血清尿素氮(BUN)水平以及较低的24小时乳酸清除率与ECMO术后30天死亡率相关。

结论

对于患有STEMI和严重CS的患者,较长的门球时间、较高的BMI、较高的血清BUN水平以及ECMO置入后较差的乳酸清除率可预测30天临床结局。

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