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体外膜肺氧合支持后创伤后应激障碍症状。

Post-traumatic stress disorder symptoms after veno-arterial extracorporeal membrane oxygenator support.

机构信息

Cardiology Department, University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Paseo San Vicente, 58-182, 37007 Salamanca, Spain.

Cardiology Department, University Hospital of Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Paseo San Vicente, 58-182, 37007 Salamanca, Spain.

出版信息

Heart Lung. 2021 Nov-Dec;50(6):775-779. doi: 10.1016/j.hrtlng.2021.06.003. Epub 2021 Jul 2.

DOI:10.1016/j.hrtlng.2021.06.003
PMID:34217987
Abstract

BACKGROUND

Post-traumatic stress disorder (PTSD) is a common long-term outcome after intensive care of critical illness.

OBJECTIVES

Assess the prevalence and factors associated to PTSD after veno-arterial extracorporeal membrane oxygenation (VA-ECMO) support.

METHODS

Retrospective analysis of admission data and cross-sectional assessment of PTSD symptoms in adult survivors from admission requiring VA-ECMO support in a referral hospital. People were screened through abbreviated Impact of Event Scale-6 (IES-6).

RESULTS

Out of 135 VA-ECMO implants performed from 2013 to 2020, 48 (35.6%) patients survived the admission. After a median follow-up of 31.4 [36] months, 34 survivors responded the questionnaire. All patients required sedation and invasive mechanical ventilation. Up to 29.4% of patients had PTSD symptoms. Patients with altered IES-6 items had passed a longer time since admission in ICCU (44±15 vs 30±20 months, p = 0.034). No baseline characteristic or admission-related variables were correlated with IES-6 except the lower time under mechanical ventilation (6.5 [8.5] vs. 8.5 [21] days, p = 0.044).

CONCLUSIONS

Survivors from admission requiring VA-ECMO support show high prevalence of PTSD symptoms, appearing more frequently when more time has elapsed since admission. Special attention should be paid to psychological symptoms after VA-ECMO support.

摘要

背景

创伤后应激障碍(PTSD)是重症监护后常见的长期后果。

目的

评估在接受静脉-动脉体外膜肺氧合(VA-ECMO)支持后 PTSD 的患病率和相关因素。

方法

回顾性分析一家转诊医院接受 VA-ECMO 支持的成人幸存者的入院数据,并进行 PTSD 症状的横断面评估。通过简短的事件影响量表-6(IES-6)进行筛选。

结果

在 2013 年至 2020 年期间进行的 135 例 VA-ECMO 植入术中,48 例(35.6%)患者存活下来。中位随访 31.4[36]个月后,34 名幸存者回答了问卷。所有患者均需镇静和有创机械通气。高达 29.4%的患者出现 PTSD 症状。IES-6 项目改变的患者在 ICU 停留的时间更长(44±15 与 30±20 个月,p=0.034)。除了机械通气时间更短(6.5[8.5]与 8.5[21]天,p=0.044)外,无基线特征或入院相关变量与 IES-6 相关。

结论

接受 VA-ECMO 支持的入院幸存者 PTSD 症状发生率较高,入院后时间越长,发病率越高。VA-ECMO 支持后应特别注意心理症状。

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