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疫情期间使用聚丙烯膜进行体外膜肺氧合支持的结果:一项回顾性队列研究。

Outcomes of ECMO support with polypropylene membrane during pandemic times: a retrospective cohort study.

机构信息

Critical care resident, Universidad de La Sabana, Chía, Colombia.

Critical Medicine and Intensive Care, Intensive care department Fundación Clínica Shaio, Bogotá DC, Colombia.

出版信息

BMC Pulm Med. 2024 Jan 19;24(1):41. doi: 10.1186/s12890-023-02753-5.

Abstract

BACKGROUND

The SARS-CoV-2 pandemic resulted in shortages of supplies, which limited the use of extracorporeal membrane oxygenation (ECMO) support. As a contingency strategy, polypropylene (PP) oxygenation membranes were used. This study describes the clinical outcomes in patients on ECMO with PP compared to poly-methylpentene (PMP) oxygenation membranes.

METHODS

Retrospective cohort of patients in ECMO support admitted between 2020 and 2021.

RESULTS

A total of 152 patients with ECMO support were included, 71.05% were men with an average age of 42 (SD 9.91) years. Veno-venous configuration was performed in 75.6% of cases. The PP oxygenation membranes required more changes 22 (63.1%), than the PMP Sorin® 24 (32,8%) and Euroset® 15 (31,9%) (p.0.022). The main indication for membrane change was low oxygen transfer for PP at 56.2%, Sorin® at 50%, and Euroset® at 14.8%. Renal replacement therapy was the most frequent complication with PP membrane in 22 patients (68.7%) Sorin® 25 patients (34.2%), and Euroset® 15 patients (31.9%) (p 0.001) without statistically significant differences in mortality.

CONCLUSION

PP oxygenation membranes was a useful and feasible strategy. It allowed a greater disponibility of ECMO support for critically ill in a situation of great adversity during the SARS-CoV-2 pandemic.

摘要

背景

SARS-CoV-2 大流行导致供应短缺,这限制了体外膜肺氧合(ECMO)的使用。作为应急策略,使用了聚丙烯(PP)氧合膜。本研究描述了与聚甲基戊烯(PMP)氧合膜相比,在 ECMO 上使用 PP 的患者的临床结局。

方法

回顾性纳入 2020 年至 2021 年期间接受 ECMO 支持的患者队列。

结果

共纳入 152 名接受 ECMO 支持的患者,71.05%为男性,平均年龄为 42(SD 9.91)岁。75.6%的患者采用静脉-静脉配置。PP 氧合膜需要更多的更换 22 次(63.1%),而 PMP Sorin® 24 次(32.8%)和 Euroset® 15 次(31.9%)(p.0.022)。更换膜的主要指征是 PP 膜的氧传递率低,为 56.2%,Sorin®为 50%,Euroset®为 14.8%。肾替代治疗是最常见的并发症,PP 膜 22 例(68.7%),Sorin®25 例(34.2%),Euroset®15 例(31.9%)(p 0.001),死亡率无统计学差异。

结论

PP 氧合膜是一种有用且可行的策略。在 SARS-CoV-2 大流行期间,在极端困难的情况下,它为重症患者提供了更多的 ECMO 支持。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7235/10797970/cf01db97d153/12890_2023_2753_Fig1_HTML.jpg

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