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Extracorporeal Membrane Oxygenation Characteristics and Outcomes in Adult Patients With Down Syndrome

机译：唐氏综合征成人患者的体外膜氧合特征及结果

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Abstract Patients with Down syndrome (DS) may have multiple medical issues that place them at risk for requiring extracorporeal membrane oxygenation. Use of extracorporeal membrane oxygenation in pediatric patients with Down syndrome has been described, but minimal data exist for extracorporeal membrane oxygenation use in adults with Down syndrome. The goal of this study was to describe the clinical characteristics and to determine if there were differences between adult extracorporeal membrane oxygenation patients with Down syndrome that were alive (aDS) versus those that died (dDS) prior to hospital discharge. Patients with Down syndrome that were 18 years and older registered in the Extracorporeal Life Support Organization registry from 1983 to 2016 were analyzed. Demographics and extracorporeal membrane oxygenation characteristics were recorded. A total of 21 adults with Down syndrome were identified. Incidence of extracorporeal membrane oxygenation in adults with Down syndrome was 0.88 per 1000 extracorporeal membrane oxygenation procedures. Hospital mortality was 57.1% (12/21). There were no significant differences between aDS versus dDS for age (24.9?±?4.8 vs. 28.1?±?10.2 years), weight (90.7?±?13.0 vs. 79.1?±?27.0 kg), gender (4 males vs. 8 males), initial pH (7.18?±?0.19 vs. 7.27?±?0.16), or initial pO2 (51.7?±?13.9 vs. 45.4?±?19.9), respectively. There were no significant differences between aDS versus dDS in duration of extracorporeal membrane oxygenation run (239?±?159 h vs. 455?±?570 h, respectively), ventilator or extracorporeal membrane oxygenation mode, and nitric oxide use. aDS had fewer incidences of mechanical and neurologic complications (41.7% vs. 0.0%, P ??0.05) versus dDS. There were no other significant differences in complication rates between the two groups. Use of extracorporeal membrane oxygenation in the adult population with Down syndrome is significantly less compared to the pediatric population with Down syndrome. Baseline characteristics are not predictive of overall survival. There were minimal differences noted between aDS versus dDS during their extracorporeal membrane oxygenation course. Mortality rates are similar to non‐Down syndrome patients placed on extracorporeal membrane oxygenation. Extracorporeal membrane oxygenation may be a reasonable option for adult patients with Down syndrome requiring intensive care.
机译：患有唐氏综合症（DS）的抽象患者可能具有多种医疗问题，使它们面临需要体外膜氧合的风险。已经描述了在小儿综合征患者中使用体外膜氧合，但对于唐氏综合征的成人体外膜氧合使用，存在最小的数据。本研究的目的是描述临床特征，并确定是否存在患有患有患有的成人体外膜氧合患者的差异，该综合征与在医院出院之前死亡（DDS）的那些与那些死亡（DDS）的那些。患有18岁及以上的综合征患者，在1983年至2016年在体外生命支持组织登记处注册，于2016年签订。记录人口统计和体外膜氧合特性。确定了21种患有唐氏综合症的成年人。每1000个体外膜氧合方法的成人体外膜氧合的发生率为0.88。医院死亡率为57.1％（12/21）。 ADS与年龄的DDS之间没有显着差异（24.9？±4.8与28.1？±10.2岁），重量（90.7？±13.0与79.1？±27.0 kg），性别（4名男性与vs. 8男性），初始pH（7.18±±0.19与7.27？±0.16），或初始PO2（51.7？±13.9与45.4？±19.9）。体外膜氧合氧合持续时间（239Ω·α159h，分别），呼吸机或体外膜氧合模式和一氧化氮使用，ADS与DDS之间没有显着差异。 ADS具有较少的机械和神经系统并发症（41.7％vs.0％，p≤0.0％，p≤0.05）。两组之间的并发症率没有其他显着差异。与唐氏综合征的儿科人群相比，在成年人群中使用体外膜氧合明显少。基线特征不是预测整体生存率。在其体外膜氧合过程中，ADS与DDS之间有最小的差异。死亡率与置于体外膜氧合的非羽绒综合征患者类似。体外膜氧合可能是成年患者的合理选择，患有重症监护的综合症。

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