接受体外膜肺氧合治疗的急性呼吸窘迫综合征患者的院内结局
In-Hospital Outcomes of Patients With Acute Respiratory Distress Syndrome Treated With Extracorporeal Membrane Oxygenation.
作者信息
Bahar Abdul Rasheed, Bahar Yasemin, Dandu Chaitu, Alrayyashi Mohamed S, Zghouzi Mohamed, Chalek Adam, Alraies M Chadi
机构信息
Internal Medicine, Wayne State University Detroit Medical Center, Detroit, USA.
Internal Medicine, Wayne State University, Detroit, USA.
出版信息
Cureus. 2024 Sep 5;16(9):e68745. doi: 10.7759/cureus.68745. eCollection 2024 Sep.
BACKGROUND
Treatment of acute respiratory distress syndrome (ARDS) with extracorporeal membrane oxygenation (ECMO) remains controversial.
OBJECTIVE
This study aims to examine outcomes in ARDS patients treated with or without ECMO.
METHODS
Using the National Inpatient Sample (NIS) database, all ARDS patients including those who were treated with ECMO were included in the analysis. Univariable and multivariable logistic regressions were used to estimate the odds of in-hospital outcomes between groups.
RESULTS
A total of 2,540,350 patients were identified (2,538,849 with ARDS; 1,501 with ARDS on ECMO). The patients who underwent ECMO included younger patients and more men. Using ECMO in ARDS patients was associated with higher in-hospital mortality, cardiopulmonary arrest, major bleeding, sepsis, acute kidney injury, and longer hospital stays (31.7 vs. 8.3 days; p < 0.001 for all). A subgroup analysis based on age and sex had similar outcomes.
CONCLUSION
Using ECMO in patients with ARDS was associated with worse in-hospital outcomes, including mortality and length of stay.
背景
体外膜肺氧合（ECMO）治疗急性呼吸窘迫综合征（ARDS）仍存在争议。
目的
本研究旨在探讨接受或未接受ECMO治疗的ARDS患者的预后情况。
方法
利用国家住院患者样本（NIS）数据库，纳入所有ARDS患者，包括接受ECMO治疗的患者。采用单变量和多变量逻辑回归分析来估计两组患者院内预后的几率。
结果
共识别出2540350例患者（2538849例ARDS患者；1501例接受ECMO治疗的ARDS患者）。接受ECMO治疗的患者包括更年轻的患者和更多男性。在ARDS患者中使用ECMO与更高的院内死亡率、心肺骤停、大出血、败血症、急性肾损伤以及更长的住院时间相关（31.7天对8.3天；所有p值均<0.001）。基于年龄和性别的亚组分析结果相似。
结论
在ARDS患者中使用ECMO与更差的院内预后相关，包括死亡率和住院时间。
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