Hayato Taniguchi is an assistant professor, Department of Surgical Intensive Care Medicine, Nippon Medical School Hospital, Tokyo, Japan, and Advanced Critical Care and Emergency Center, Yokohama City University Medical Center, Yokohama, Japan.
Tokuji Ikeda is an assistant professor, Department of Surgical Intensive Care Medicine, Nippon Medical School Hospital.
Am J Crit Care. 2021 Jan 1;30(1):55-63. doi: 10.4037/ajcc2021351.
Iliopsoas hematoma occasionally occurs in patients receiving anticoagulation therapy. It may be a life-threatening complication and can cause disseminated intravascular coagulation, which could develop into abdominal compartment syndrome. The incidence of and factors associated with iliopsoas hematoma during venovenous extracorporeal membrane oxygenation (ECMO) have not been well studied.
To describe the incidence of iliopsoas hematoma and associated factors among patients undergoing venovenous ECMO.
A retrospective cohort study was conducted at Nippon Medical School Hospital from April 2015 to October 2018. All patients (>18 years old) with iliopsoas hematoma received a diagnosis based on computed tomography.
During the study period, 54 patients were supported with venovenous ECMO. Iliopsoas hematoma occurred in 8 of those patients (15%), none of whom had disseminated intravascular coagulopathy or abdominal compartment syndrome develop. Univariate analysis indicated that management of ECMO while the patient was awake and mobilization beyond sitting on the edge of the bed were significantly different (P < .05) in patients with and patients without iliopsoas hematoma. Mortality, however, did not differ significantly between the 2 groups.
Our findings emphasize that recognizing factors associated with iliopsoas hematoma and detecting them early are crucial during venovenous ECMO in order to treat patients with iliopsoas hematoma appropriately.
接受抗凝治疗的患者偶尔会发生髂腰肌血肿。它可能是一种危及生命的并发症，并可导致弥散性血管内凝血，进而发展为腹腔间隔室综合征。静脉-静脉体外膜肺氧合（ECMO）期间髂腰肌血肿的发生率和相关因素尚未得到很好的研究。
描述静脉-静脉 ECMO 患者中髂腰肌血肿的发生率和相关因素。
这是一项在日本医科大学医院进行的回顾性队列研究，时间为 2015 年 4 月至 2018 年 10 月。所有接受髂腰肌血肿诊断的患者（>18 岁）均基于计算机断层扫描。
在研究期间，54 例患者接受了静脉-静脉 ECMO 支持。其中 8 例（15%）患者发生髂腰肌血肿，均未发生弥散性血管内凝血或腹腔间隔室综合征。单因素分析表明，在有和没有髂腰肌血肿的患者中，ECMO 管理时患者清醒和超越坐在床边的活动有显著差异（P <.05）。然而，两组患者的死亡率无显著差异。
我们的研究结果强调，在静脉-静脉 ECMO 期间，认识与髂腰肌血肿相关的因素并早期发现这些因素对于恰当治疗髂腰肌血肿患者至关重要。
