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细胞吸附剂在 VA-ECMO 患者中的应用可增加尿量并提高 ICU 存活率。

The addition of Cytosorb in patients on VA-ECMO improves urinary output and ICU survival.

机构信息

Cardiology Clinic, University Hospital Center Zagreb, Zagreb, Croatia.

Franziskus Spital, Wien, Austria.

出版信息

Ther Apher Dial. 2024 Feb;28(1):103-111. doi: 10.1111/1744-9987.14064. Epub 2023 Sep 11.

Abstract

INTRODUCTION

The aim of this study was to analyze the efficiency of CytoSorb adsorber in patients presenting with cardiogenic shock and treated with venoarterial extracorporeal membrane oxygenation (VA-ECMO).

METHODS

Sixteen patients put on VA ECMO due to cardiogenic shock were included, stratified according to the use of Cytosorb adsorber in the first 24 h and compared across different clinical outcomes.

RESULTS

Significantly lower vasopressor doses were required among patients treated with Cytosorb at the initiation and before weaning from ECMO. Furthermore, these patients showed significantly higher urine output before weaning and lower lactate levels during the extracorporeal support. Finally, the mortality rate was lower among the Cytosorb therapy group (22.2% vs 57.1%).

CONCLUSION

While a decrease in vasopressor doses was already associated with CytoSorb use, this is the first study showing an increase in urinary output and a trend towards better survival among patients on VA ECMO treated with CytoSorb.

摘要

简介

本研究旨在分析在因心源性休克而接受静脉-动脉体外膜肺氧合(VA-ECMO)治疗的患者中使用 CytoSorb 吸附器的效率。

方法

共纳入 16 例因心源性休克而接受 VA-ECMO 的患者,根据在最初 24 小时内使用 CytoSorb 吸附器的情况进行分层,并比较不同的临床结局。

结果

在开始和从 ECMO 脱机时使用 CytoSorb 治疗的患者需要的血管加压剂剂量明显较低。此外,这些患者在脱机前的尿量明显增加,体外支持期间的乳酸水平较低。最后,在 CytoSorb 治疗组的死亡率较低(22.2% vs 57.1%)。

结论

虽然血管加压剂剂量的降低已经与 CytoSorb 的使用相关,但这是第一项研究表明,在接受 VA-ECMO 治疗的患者中,使用 CytoSorb 可增加尿量,并显示出更好的生存趋势。

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