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超声评估行体外膜肺氧合治疗的心源性休克患者肺部变化的回顾性研究。

Lung ultrasound to evaluate pulmonary changes in patients with cardiogenic shock undergoing extracorporeal membrane oxygenation: a retrospective study.

机构信息

Department of Anesthesiology, Xuzhou Central Hospital, Xuzhou, China.

Department of Respiratory, Xuzhou Central Hospital, Xuzhou, China.

出版信息

BMC Anesthesiol. 2023 May 25;23(1):181. doi: 10.1186/s12871-023-02134-9.

Abstract

PURPOSE

The aim of the study was to evaluate the value of lung ultrasound (LUS) in patients with cardiogenic shock treated by venoarterial extracorporeal membrane oxygenation (VA-ECMO).

METHODS

A retrospective study was conducted in Xuzhou Central Hospital from September 2015 to April 2022. Patients with cardiogenic shock who received VA-ECMO treatment were enrolled in this study. The LUS score was obtained at the different time points of ECMO.

RESULTS

Twenty-two patients were divided into a survival group (n = 16) and a nonsurvival group (n = 6). The intensive care unit (ICU) mortality was 27.3% (6/22). The LUS scores in the nonsurvival group were significantly higher than those in the survival group after 72 h (P < 0.05). There was a significant negative correlation between LUS scores and PaO/FiO and LUS scores and pulmonary dynamic compliance(Cdyn) after 72 h of ECMO treatment (P < 0.001). ROC curve analysis showed that the area under the ROC curve (AUC) of T-LUS was 0.964 (95% CI 0.887 ~ 1.000, P < 0.01).

CONCLUSION

LUS is a promising tool for evaluating pulmonary changes in patients with cardiogenic shock undergoing VA-ECMO.

TRIAL REGISTRATION

The study had been registered in the Chinese Clinical Trial Registry(NO.ChiCTR2200062130 and 24/07/2022).

摘要

目的

本研究旨在评估肺超声(LUS)在接受静脉-动脉体外膜肺氧合(VA-ECMO)治疗的心源性休克患者中的价值。

方法

本研究为回顾性研究,于 2015 年 9 月至 2022 年 4 月在徐州市中心医院进行。纳入接受 VA-ECMO 治疗的心源性休克患者,在 ECMO 的不同时间点获取 LUS 评分。

结果

22 例患者分为存活组(n=16)和死亡组(n=6)。重症监护病房(ICU)死亡率为 27.3%(6/22)。存活组和死亡组患者在 ECMO 治疗 72 h 后 LUS 评分均升高,且死亡组明显高于存活组(P<0.05)。ECMO 治疗 72 h 后,LUS 评分与 PaO/FiO 和肺动态顺应性(Cdyn)呈显著负相关(P<0.001)。ROC 曲线分析显示,T-LUS 的曲线下面积(AUC)为 0.964(95%CI 0.887~1.000,P<0.01)。

结论

LUS 是评估接受 VA-ECMO 治疗的心源性休克患者肺部变化的一种很有前途的工具。

试验注册

本研究已在中国临床试验注册中心注册(注册号 ChiCTR2200062130 和 24/07/2022)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fdf0/10210289/465e337991d0/12871_2023_2134_Fig1_HTML.jpg

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