Advanced Critical Care and Emergency Centre, Yokohama City University Medical Centre, Yokohama, Japan.
Critical Care Research Group, The Prince Charles Hospital and The University of Queensland, Rode Road, Chermside, QLD, Australia.
Perfusion. 2024 Jul;39(5):891-895. doi: 10.1177/02676591231168285. Epub 2023 Mar 29.
Iliopsoas haematoma (IPH) during extracorporeal membrane oxygenation (ECMO) is a rare bleeding complication that can be fatal due to its progression to abdominal compartment syndrome, but its incidence and risk factors are not well known. We have previously reported an IPH incidence rate of 16% in Japan. Among possible reasons for this high incidence, ethnicity has been hypothesised to play a role. Therefore, we used an international multi-centre cohort registry to test this hypothesis by determining the incidence rate of IPH.
This study was performed using the COVID-19 Critical Care Consortium database, conducted in 30 countries across five continents between 3 January 2020, and 20 June 2022.
Overall, 1102 patients received ECMO for COVID-19-related acute respiratory distress syndrome. Of them, only seven were reported to have IPH, indicating an incidence rate of 0.64%, with comparable rates between the countries. The IPH group tended to have a higher mortality rate (71.4%) than the non-IPH group (51%).
Overall incidence of IPH in the studied COVID-19 ECMO cohort was 0.64%. Most cases were reported from Japan, Belgium, and Italy. In our study, this rare complication did not appear to be confined to Asian patients. Due to the high fatality rate, awareness about the occurrence of IPH should be recognised.
体外膜肺氧合（ECMO）期间的髂腰肌血肿（IPH）是一种罕见的出血并发症，由于其进展为腹腔间隔室综合征，可能导致致命，但该病的发病率和危险因素尚不清楚。我们之前报道过日本的 IPH 发病率为 16%。在导致高发病率的诸多可能原因中，有人假设种族起了一定作用。因此，我们使用国际多中心队列登记处，通过确定 IPH 的发病率来检验这一假设。
这项研究使用了 COVID-19 危重症护理联合会数据库，该数据库于 2020 年 1 月 3 日至 2022 年 6 月 20 日在五大洲的 30 个国家进行。
总体而言，1102 例 COVID-19 相关急性呼吸窘迫综合征患者接受了 ECMO 治疗。其中仅 7 例报告有 IPH，发病率为 0.64%，各国间发病率相似。IPH 组的死亡率（71.4%）高于非 IPH 组（51%）。
在研究的 COVID-19 ECMO 队列中，IPH 的总体发病率为 0.64%。大多数病例报告来自日本、比利时和意大利。在我们的研究中，这种罕见的并发症似乎并非局限于亚洲患者。由于高死亡率，应认识到发生 IPH 的可能性。
