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在德国一家大型囊性纤维化中心,对接受静脉-静脉体外膜肺氧合(VV ECMO)支持的成年囊性纤维化患者进行的回顾性队列研究。

Retrospective cohort study of adult patients with cystic fibrosis supported with venovenous extracorporeal membrane oxygenation (VV ECMO) at a large German cystic fibrosis center.

作者信息

Grünewaldt Achim, Rohde Gernot

机构信息

Department of Respiratory Medicine and Allergology, University Hospital, Goethe University, Frankfurt, Germany.

出版信息

BMC Pulm Med. 2025 Jun 2;25(1):276. doi: 10.1186/s12890-025-03745-3.

Abstract

BACKGROUND

Severe respiratory failure in patients with cystic fibrosis (CF) requiring invasive mechanical ventilation is associated with poor clinical outcomes. The purpose of this study was to evaluate the role of extracorporeal membrane oxygenation (ECMO) in this clinical setting.

METHODS

In this descriptive retrospective monocentric cohort study, we collected data by using electronic medical records from all patients with CF who received ECMO therapy during the period 2012-2021.

SETTING

A monocentric setting at the non-surgical intensive care unit of the University Hospital of Frankfurt, Germany (tertiary care level center and nationally certified CF center).

RESULTS

During the study period 72 cases of CF patients with intensive care treatment were detected. Of these, 46 cases required mechanical ventilation. Nine patients received ECMO therapy for severe respiratory failure due to pulmonary exacerbation. Eight of the nine patients died in the hospital. This corresponds to an in-hospital mortality rate of 88.9%. None of the patients underwent lung transplantation. The most common CF mutation was the p.Phe508del homo- or heterozygous genotype. Pseudomonas aeruginosa colonization was significantly associated with the in-hospital mortality.

CONCLUSIONS

ECMO support in CF patients and severe hypoxemic failure is associated with high mortality and its use must take into account the increased risk and poor patient outcome in this clinical setting.

CLINICAL TRIAL NUMBER

This was a retrospective, unregistered analysis. A clinical trial number is not applicable.

摘要

背景

患有囊性纤维化(CF)的患者出现严重呼吸衰竭且需要有创机械通气,其临床预后较差。本研究的目的是评估体外膜肺氧合(ECMO)在这种临床情况下的作用。

方法

在这项描述性回顾性单中心队列研究中,我们通过电子病历收集了2012年至2021年期间所有接受ECMO治疗的CF患者的数据。

背景

德国法兰克福大学医院非手术重症监护病房的单中心环境(三级护理水平中心和国家认证的CF中心)。

结果

在研究期间,共检测到72例接受重症监护治疗的CF患者。其中,46例需要机械通气。9例患者因肺部病情加重导致严重呼吸衰竭而接受了ECMO治疗。9例患者中有8例在医院死亡。这相当于院内死亡率为88.9%。所有患者均未接受肺移植。最常见的CF突变是p.Phe508del纯合或杂合基因型。铜绿假单胞菌定植与院内死亡率显著相关。

结论

CF患者和严重低氧血症性呼吸衰竭接受ECMO支持与高死亡率相关,在这种临床情况下使用ECMO必须考虑到风险增加和患者预后不良。

临床试验编号

这是一项回顾性、未注册的分析。不适用临床试验编号。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d4b2/12128227/38c31377324e/12890_2025_3745_Fig1_HTML.jpg

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本文引用的文献

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