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体外膜肺氧合(ECMO)幸存者出院后抑郁状态:静脉-静脉ECMO与静脉-动脉ECMO的比较

Post-Discharge Depression Status for Survivors of Extracorporeal Membrane Oxygenation (ECMO): Comparison of Veno-Venous ECMO and Veno-Arterial ECMO.

作者信息

Lin Wan-Jung, Chang Yu-Ling, Weng Li-Chueh, Tsai Feng-Chun, Huang Huei-Chiun, Yeh Shu-Ling, Chen Kang-Hua

机构信息

Department of Nursing, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei 100, Taiwan.

School of Nursing, College of Medicine, Chang Gung University, Taoyuan City 333, Taiwan.

出版信息

Int J Environ Res Public Health. 2022 Mar 11;19(6):3333. doi: 10.3390/ijerph19063333.

Abstract

Extracorporeal membrane oxygenation (ECMO) is one of the common invasive treatments for the care of critically ill patients with heart failure, respiratory failure, or both. There are two modes of ECMO, namely, veno-venous (VV) and veno-arterial (VA), which have different indications, survival rates, and incidences of complications. This study's aim was to examine whether depression status differed between patients who had received VV-ECMO or VA-ECMO and had been discharged from the hospital. This was a descriptive, cross-sectional, and correlational study of patients who had been discharged from the hospital at least one month after receiving ECMO at a medical center in northern Taiwan from June 2006 to June 2020 ( = 142). Participants were recruited via convenience and quota sampling. Data were collected in the cardiovascular outpatient department between October 2015-October 2016 ( = 52) and September 2019-August 2020 ( = 90). Participants completed the Hospital Anxiety and Depression Scale-Depression (HADS-D) as a measure of depression status. Post-discharge depression scores for patients who received VV-ECMO ( = 67) was significantly higher ( = 0.018) compared with participants who received VA-ECMO ( = 75). In addition, the mode of ECMO was a predictor of post-discharge depression ( = 0.008) for participants who received VV-ECMO. This study concluded that patients who received VV-ECMO may require greater mental health support. Healthcare professionals should establish a psychological clinical care pathway evaluated by multiple healthcare professionals.

摘要

体外膜肺氧合(ECMO)是治疗心力衰竭、呼吸衰竭或两者兼具的危重症患者常用的侵入性治疗方法之一。ECMO有两种模式,即静脉-静脉(VV)模式和静脉-动脉(VA)模式,它们的适应症、生存率和并发症发生率各不相同。本研究的目的是探讨接受VV-ECMO或VA-ECMO并已出院的患者之间抑郁状态是否存在差异。这是一项对2006年6月至2020年6月在台湾北部一家医疗中心接受ECMO治疗后至少出院一个月的患者进行的描述性、横断面和相关性研究(n = 142)。参与者通过便利抽样和配额抽样招募。数据于2015年10月至2016年10月(n = 52)以及2019年9月至2020年8月(n = 90)在心血管门诊收集。参与者完成医院焦虑抑郁量表-抑郁(HADS-D)以测量抑郁状态。接受VV-ECMO的患者(n = 67)出院后的抑郁评分显著高于接受VA-ECMO的参与者(n = 75)(p = 0.018)。此外,对于接受VV-ECMO的参与者,ECMO模式是出院后抑郁的一个预测因素(p = 0.008)。本研究得出结论,接受VV-ECMO的患者可能需要更多的心理健康支持。医疗保健专业人员应建立一条由多名医疗保健专业人员评估的心理临床护理路径。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/01e1/8954682/e00a2e69c151/ijerph-19-03333-g001.jpg

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