经静脉-静脉体外膜肺氧合支持的患者行经皮气管切开术插入相关出血并发症：10 年机构经验。

Bleeding Complications Associated With Percutaneous Tracheostomy Insertion in Patients Supported With Venovenous Extracorporeal Membrane Oxygen Support: A 10-Year Institutional Experience.

机构信息

Department of Anaesthesia and Intensive Care, Papworth Hospital NHS Foundation Trust, Cambridge, UK.

出版信息

J Cardiothorac Vasc Anesth. 2018 Jun;32(3):1162-1166. doi: 10.1053/j.jvca.2017.08.010. Epub 2017 Aug 3.

OBJECTIVES

To evaluate the bleeding complications associated with percutaneous tracheostomy while a patient is receiving venovenous extracorporeal membrane oxygen (VV ECMO) support.

DESIGN

Retrospective, observational analysis.

SETTING

Single-center, tertiary, academic institution.

PARTICIPANTS

All consecutive patients on VV ECMO over a 10 year-period undergoing percutaneous tracheostomy.

INTERVENTIONS

Percutaneous tracheostomy.

MEASUREMENTS AND MAIN RESULTS

Fifty percutaneous tracheostomies were performed in patients requiring VV ECMO support over the 10-year period. The authors observed a 40% incidence of bleeding, with 32% of these incidences characterized as minor (self-limiting, localized stomal ooze) and 8% characterized as significant (necessitating surgical control and frequent packing or accompanied by a decrease in hemoglobin >20%).

CONCLUSIONS

Bleeding is associated with percutaneous tracheostomy and is self-limiting in the majority of patients.

目的

评估患者接受静脉-静脉体外膜肺氧合（VV ECMO）支持时经皮气管切开术相关的出血并发症。

设计

回顾性观察性分析。

地点

单中心、三级、学术机构。

参与者

在 10 年期间接受 VV ECMO 的所有连续患者均进行经皮气管切开术。

干预措施

经皮气管切开术。

测量和主要结果

在 10 年期间，需要 VV ECMO 支持的患者中进行了 50 例经皮气管切开术。作者观察到出血发生率为 40%，其中 32%的出血程度较轻（自限性，局部气管瘘口渗血），8%的出血程度较重（需要手术控制和频繁填塞，或伴有血红蛋白下降>20%）。

结论

经皮气管切开术与出血相关，大多数患者的出血是自限性的。