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体外膜肺氧合脱管后套管相关的深静脉血栓形成:发生率及危险因素

Cannula-Associated Deep Vein Thrombosis Following Extracorporeal Membrane Oxygenation Decannulation: Incidence and Risk Factors.

作者信息

Trieu Ngan Hoang Kim, Pham Huy Minh, Mai Tuan Anh, Huynh Dai Quang, Tran Linh Thanh, Phan Xuan Thi, Pham Thao Thi Ngoc

机构信息

From the Department of Critical Care Medicine, Cho Ray Hospital, Ho Chi Minh City, Vietnam.

University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam.

出版信息

ASAIO J. 2025 Feb 1;71(2):164-170. doi: 10.1097/MAT.0000000000002289. Epub 2024 Aug 1.

Abstract

Thrombotic complications during and after extracorporeal membrane oxygenation (ECMO) are commonly observed clinically. The incidences of cannula-associated deep vein thrombosis (CaDVT) post-ECMO support have predominantly focused on Caucasian demographics. This study aims to determine the incidence and risk factors for CaDVT in Vietnamese patients following ECMO decannulation. The retrospective study from January 2019 to February 2020 observed ECMO weaning patients and screened for CaDVT using Doppler ultrasonography. Data were collected on patient demographics, ECMO parameters, and transfusion and coagulation profiles during ECMO support. Of the 82 patients successfully weaned ECMO, 89% were assessed for CaDVT. We observed a CaDVT incidence of 24.7%, and only one patient (5.6%) had a pulmonary embolism in the CaDVT group. Noteworthy is that the anticoagulation goals, transfusion during ECMO, and hospital mortality showed no significant difference between the CaDVT and non-CaDVT groups. The findings showed that the duration of ECMO support is a risk factor for CaDVT. The incidence of CaDVT following ECMO decannulation was 24.7%, and the diagnosis of CaDVT can be underestimated. Therefore, we suggest routine screening for CaDVT after cannula removal.

摘要

体外膜肺氧合(ECMO)期间及之后的血栓形成并发症在临床上较为常见。ECMO支持后与插管相关的深静脉血栓形成(CaDVT)的发生率主要集中在白种人群体。本研究旨在确定越南患者ECMO拔管后CaDVT的发生率及危险因素。对2019年1月至2020年2月的回顾性研究观察了ECMO撤机患者,并使用多普勒超声筛查CaDVT。收集了患者人口统计学、ECMO参数以及ECMO支持期间的输血和凝血指标等数据。在82例成功撤机的患者中,89%接受了CaDVT评估。我们观察到CaDVT发生率为24.7%,CaDVT组中仅有1例患者(5.6%)发生肺栓塞。值得注意的是,CaDVT组与非CaDVT组在抗凝目标、ECMO期间的输血情况及医院死亡率方面无显著差异。研究结果表明,ECMO支持时间是CaDVT的一个危险因素。ECMO拔管后CaDVT的发生率为24.7%,CaDVT的诊断可能被低估。因此,我们建议在拔管后常规筛查CaDVT。

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