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首页> 外文期刊>Artificial Organs >Cannulation-Related Complications on Veno-Arterial Extracorporeal Membrane Oxygenation: Prevalence and Effect on Mortality
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Cannulation-Related Complications on Veno-Arterial Extracorporeal Membrane Oxygenation: Prevalence and Effect on Mortality

机译：静脉动脉体外膜氧合的固化相关并发症：流行和对死亡率的影响

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Cannulation-related complications are a known source of morbidity in patients supported on veno-arterial extracorporeal membrane oxygenation (VA-ECMO). Despite its prevalence, little is known regarding the outcomes of patients who suffer such complications. This is a single institution review of cannulation-related complications and its effect on mortality in patients supported on VA-ECMO from January 2010-2015 using three cannulation strategies: axillary, femoral, and central. Complications were defined as advanced if they required major interventions (fasciotomy, amputation, site conversion). Patients were divided into two groups (complication present vs. not present) and Kaplan-Meier analysis was performed to determine any differences in their survival distributions. There were 103 patients supported on VAECMO: 41 (40%), 36 (35%), and 26 (25%) were cannulated via axillary, femoral, and central access, respectively. Cannulation-related complications occurred in 33 (32%) patients and this did not differ significantly between either axillary (34%), femoral (36%), or central (23%) strategies (P=0.52). The most common complications encountered were hemorrhage and limb ischemia in 19 (18%) and 11 (11%) patients. Hemorrhagic complications did not differ between groups (P=0.37), while limb ischemia and hyperperfusion were significantly associated with femoral and axillary cannulation, at a rate of 25% (P<0.01) and 15% (P=0.01), respectively. There was no difference in the incidence of advanced complications between cannulation groups: axillary (12%) vs. femoral (14%) vs. central (8%; P=0.75). In addition, no increase in mortality was noted in patients who developed a cannulation-related complication by Kaplan-Meier estimates (P=0.37). Cannulation-related complications affect a significant proportion of patients supported on VA-ECMO but do not differ in incidence between different cannulation strategies and do not affect patient mortality. Improved efforts at preventing these complications need to be developed to avoid the additional morbidity in an already critical patient population.
机译：相关的并发症是静脉动脉体外膜氧合（Va-Ecmo）支持的患者的已知发病源。尽管它流行，但对于患有此类并发症的患者的结果很少。这是一项关于加工相关的并发症的单一机构审查，其使用三项插管策略从2010 - 2015年1月（2010年1月）对VA-ECMO支持的患者的影响：腋生，股骨和中央。如果他们需要主要干预措施（Fasciofy，截肢，网站转换），并发症被定义为先进。患者分为两组（并发症与不存在的并发症），并进行KAPLAN-MEIER分析以确定其存活分布的任何差异。 VAECMO支持103名患者：41（40％），36（35％）和26（25％）分别通过腋窝，股骨和中央进入装箱。在33名（32％）患者中发生了相关的并发症，并且腋生（34％），股骨（36％）或中央（23％）策略（P = 0.52）之间没有显着差异。遇到的最常见的并发症是19（18％）和11名（11％）患者的出血和肢体缺血。出血性并发症在群体之间没有差异（p = 0.37），而肢体缺血和血管灌注率显着与股骨和腋窝插管显着相关，分别为25％（P <0.01）和15％（P = 0.01）。插管组之间的先进并发症发生率没有差异：腋生（12％）与股骨（14％）与中央（8％; P = 0.75）。此外，通过Kaplan-Meier估算开发了外套相关并发症的患者没有提高死亡率（P = 0.37）。相关的并发症会影响VA-ECMO支持的大部分患者，但在不同的插管策略之间的发病率没有差异，不会影响患者死亡率。需要制定改善预防这些并发症的努力，以避免已经关键的患者人口中的额外发病率。

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