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机械循环支持装置受者的预防和感染管理。

Prevention and Infection Management in Mechanical Circulatory Support Device Recipients.

机构信息

Infectious Diseases Division,

Cardiothoracic Surgery Division, Mayo Clinic, Phoenix, Arizona; and.

出版信息

Clin Infect Dis. 2017 Jan 15;64(2):222-228. doi: 10.1093/cid/ciw698. Epub 2016 Nov 9.

Abstract

There are currently no guidelines for the management of infection and its prevention in mechanical circulatory support (MCS) device recipients. The International Society of Heart and Lung Transplantation (ISHLT) has initiated a multidisciplinary collaboration for the creation of a consensus document to guide clinicians in infection prevention and management in MCS patients. Most medical centers use local protocols that are based on expert opinion. MCS recipients are debilitated and have some immunological dysfunction. Over the years there have been technical advancements with smaller devices and drivelines with improved durability. The pulsatile devices have been replaced with newer-generation continuous-flow devices. Patient are living longer with MCSs for bridge to transplant (BTT) and destination therapy (DT). MCS centers have improved patient management by introducing standardized driveline protocols, leading to reduced infection rates among MCS recipients.

摘要

目前,机械循环支持(MCS)装置受者的感染管理及其预防尚无指南。国际心肺移植学会(ISHLT)已启动了一项多学科合作,以制定一份共识文件,指导临床医生在 MCS 患者的感染预防和管理方面的工作。大多数医疗中心使用的是基于专家意见的本地方案。MCS 受者身体虚弱,免疫功能存在一定障碍。多年来,随着更小的设备和改进了耐用性的驱动轴的技术进步,搏动性设备已被新一代连续流动设备所取代。MCS 受者因桥接移植(BTT)和终点治疗(DT)而寿命更长。MCS 中心通过引入标准化的驱动轴方案来改善患者管理,从而降低了 MCS 受者的感染率。

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