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Contemporary optimal therapeutic strategy with escalation/de-escalation of temporary mechanical circulatory support in patients with cardiogenic shock and advanced heart failure in Japan. 日本心源性休克和晚期心力衰竭患者临时机械循环支持升级/降级的当代最佳治疗策略。
IF 1.1 4区 医学 Q4 ENGINEERING, BIOMEDICAL Pub Date : 2024-09-08 DOI: 10.1007/s10047-024-01471-x
Makiko Nakamura, Teruhiko Imamura, Kinugawa Koichiro

The utilization of temporary mechanical circulatory support (MCS) in the management of cardiogenic shock is experiencing a notable surge. Acute myocardial infarction remains the predominant etiology of cardiogenic shock, followed by heart failure. Recent findings from the DanGer Shock trial indicate that the percutaneous micro-axial flow pump support, in conjunction with standard care, significantly reduced 6-month mortality in patients with acute myocardial infarction-related cardiogenic shock compared to those receiving standard care alone. However, real-world registry data reveal that the 30-day mortality among patients with acute myocardial infarction-related cardiogenic shock, who received concomitant veno-arterial extracorporeal membrane oxygenation support along with micro-axial flow pump, remain suboptimal. The persistent challenge in the field is how to incorporate, escalate, and de-escalate these temporary MCS to further improve clinical outcomes in such clinical scenarios. This review aims to elucidate the current practices surrounding the escalation and de-escalation of temporary MCS in real-world clinical settings and proposes considerations for future advancements in this critical area.

在治疗心源性休克的过程中,使用临时机械循环支持(MCS)的患者明显增多。急性心肌梗死仍是心源性休克的主要病因,其次是心力衰竭。DanGer 休克试验的最新研究结果表明,与单独接受标准治疗的患者相比,经皮微轴流泵支持与标准治疗相结合可显著降低急性心肌梗死相关心源性休克患者的 6 个月死亡率。然而,真实世界的登记数据显示,同时接受静脉-动脉体外膜氧合支持和微轴流泵支持的急性心肌梗死相关心源性休克患者的 30 天死亡率仍未达到最佳水平。该领域一直面临的挑战是如何结合、升级和降级这些临时性体外膜肺氧合支持,以进一步改善此类临床情况下的临床预后。本综述旨在阐明当前在实际临床环境中围绕临时性 MCS 的升级和降级的做法,并为这一关键领域的未来发展提出建议。
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引用次数: 0
Durable left ventricular assist devices in pediatrics: impact of body size on outcomes and size limitations. 儿科耐用左心室辅助装置:体型对疗效和尺寸限制的影响。
IF 1.1 4区 医学 Q4 ENGINEERING, BIOMEDICAL Pub Date : 2024-09-06 DOI: 10.1007/s10047-024-01467-7
Mimi Xiaoming Deng, Nao Yoshida, Christoph Haller, Aamir Jeewa, Shi-Joon Yoo, Osami Honjo

Despite the range of body sizes in children, few ventricular assist devices (VAD) exist to support pediatric patients with end-stage heart failure. Large registry data identified weight < 20 kg to be associated with higher rates of VAD-related stroke, compared to > 40 kg. Moreover, patients < 1 years of age experience the highest post-implant mortality, with 1-year survival improving in an age-dependent manner. Within different VAD types, intracorporeal continuous (IC) devices confer the greatest clinical benefit and quality of life compared to paracorporeal alternatives. The major limitation of IC VADs is the technical challenge of implantation into patients of small body size, thus the majority of patients with IC devices are pre-adolescents or older. However, since 2021, the use of HeartMate 3™ (HM3) has expanded to patients as small as 17.7 kg. Although HM3 offers equally favorable survival outcomes irrespective of body size, patients of low body surface area are more likely to experience non-device-related major infections and renal dysfunction, with suggestion for elevated risk of major bleeding and stroke. Innovative imaging strategies have emerged to assess the feasibility of HM3 implantation and facilitate preoperative planning in small children. Moreover, the unmet need for an IC device in the infant population has revived interest in the axial pump, with a pivotal clinical trial currently underway. VAD outcomes in the pediatric population are not equivalent across all ages and body sizes, thus size-stratified analyses and device development to serve the full spectrum of body habitus are key considerations as this field rapidly evolves.

尽管儿童的体型大小不一,但用于支持终末期心力衰竭儿科患者的心室辅助装置(VAD)却寥寥无几。大量登记数据显示,儿童体重为 40 千克。此外,患者
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引用次数: 0
Body fluid volume calculated using the uric acid kinetic model relates to the vascular event. 使用尿酸动力学模型计算的体液容量与血管事件有关。
IF 1.1 4区 医学 Q4 ENGINEERING, BIOMEDICAL Pub Date : 2024-09-01 Epub Date: 2023-12-11 DOI: 10.1007/s10047-023-01421-z
Shigeru Nakai, Takahito Ito, Kazuhiko Shibata, Kiyoshi Ozawa, Teppei Matsuoka, Kanenori Maeda, Yasushi Ohashi, Takayuki Hamano, Norio Hanafusa, Takahiro Shinzato, Susumu Ookawara, Ikuto Masakane

Purpose: We developed a method to measure the extracellular and intracellular fluid volumes using the kinetics of uric acid in the bodies of Japanese patients undergoing dialysis. In this research, we aimed to assess the prognosis of vascular events using this uric acid kinetic model method.

Methods: We conducted a retrospective cohort study of 1,298 patients who were undergoing hemodialysis or predilution online hemodiafiltration at the end of December 2019 at 13 institutions in Japan. Information on vascular events was acquired in 2020. Vascular event prognosis was defined as the new incidence of one or more of the following four types of vascular events: myocardial infarction, cerebral infarction, cerebral hemorrhage, or limb amputation. We measured the extracellular fluid volume and intracellular fluid volume after dialysis using the uric acid kinetic model method and determined the association between ECV, ICV, and vascular event risk.

Results: A high extracellular volume was substantially linked to an increased risk of vascular events. In addition, while a crude analysis revealed that a high intracellular volume was associated with a low risk of vascular events, this was not statistically significant after multifactorial adjustment. This result was partly affected by the low measurement accuracy of the serum urea nitrogen level used for the intracellular volume calculation.

Conclusions: Extracellular volume calculated using the uric acid kinetic model method is a prognostic factor for vascular events in patients undergoing hemodialysis.

目的:我们开发了一种利用日本透析患者体内尿酸动力学测量细胞外液和细胞内液容量的方法。在这项研究中,我们旨在利用这种尿酸动力学模型方法评估血管事件的预后:我们对2019年12月底在日本13家机构接受血液透析或预稀释在线血液透析的1298名患者进行了回顾性队列研究。有关血管事件的信息于 2020 年获得。血管事件预后被定义为以下四种血管事件中一种或多种的新发生率:心肌梗死、脑梗死、脑出血或肢体截肢。我们使用尿酸动力学模型法测量了透析后的细胞外液容量和细胞内液容量,并确定了ECV、ICV与血管事件风险之间的关联:结果:细胞外液容量高与血管事件风险增加有很大关系。此外,虽然粗略分析显示细胞内容量大与血管事件风险低有关,但经多因素调整后,这一结果在统计学上并不显著。这一结果部分受到了用于计算细胞内容量的血清尿素氮水平测量准确性较低的影响:结论:使用尿酸动力学模型方法计算的细胞外容量是血液透析患者发生血管事件的预后因素。
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引用次数: 0
Spiral groove bearing design for improving plasma skimming in rotary blood pumps. 螺旋槽轴承设计用于改善旋转式血泵的血浆撇取效果。
IF 1.1 4区 医学 Q4 ENGINEERING, BIOMEDICAL Pub Date : 2024-09-01 Epub Date: 2023-12-28 DOI: 10.1007/s10047-023-01422-y
Ming Jiang, Wataru Hijikata

High-efficiency plasma skimming is hopeful to prevent hemolysis inside spiral groove bearings (SGBs) because it can exclude red blood cells from the ridge gap with a high shear force. However, no study reveals the shape design of SGBs to improve plasma skimming. Therefore, this study proposed and applied a groove design strategy to designing an optimal SGB for enhancing plasma skimming in a rotary blood pump (RBP). Initially, we proposed the design strategy that the shape of the groove for enhancing plasma skimming corresponds to the direction of blood flow in the ridge gap. Second, we visualized the cell flow in a specially designed experimental RBP to determine the direction of blood flow, which was helpful in the subsequent SGB design. Then, we created an SGB to provide superior plasma skimming and applied it to the experimental RBP. We evaluated the plasma skimming effect of SGB at rotational speeds ranging from 2400 to 3000 rpm and hematocrit conditions between 1% and 40%. At a 1% hematocrit, the plasma skimming efficiency for the entire SGB was greater than 95%. In all hematocrit conditions, the efficiency at the inner ridges of the SGB was greater than 80%. The results showed the designed SGB successfully induced excellent plasma skimming within ridge gaps. This study is the first to propose and apply a shape design strategy to generate excellent plasma skimming within an SGB. This study may contribute to the prevention of SGB hemolysis inside SGB for use in RBPs.

螺旋槽轴承(SGB)内的高效血浆撇取可将红细胞从具有高剪切力的脊间隙中排除,因此有希望防止溶血。然而,目前还没有研究揭示如何设计螺旋槽轴承的形状以改善血浆撇取效果。因此,本研究提出并应用了一种凹槽设计策略,以设计出一种最佳的 SGB,从而提高旋转血液泵(RBP)的血浆撇取能力。首先,我们提出的设计策略是,用于加强血浆撇取的凹槽形状与脊隙中的血流方向相对应。其次,我们对专门设计的实验 RBP 中的细胞流进行了可视化,以确定血流方向,这有助于随后的 SGB 设计。然后,我们设计了一种能提供出色血浆撇取效果的 SGB,并将其应用于实验 RBP。我们评估了 SGB 在 2400 至 3000 转/分钟的转速和 1%至 40% 的血细胞比容条件下的血浆撇取效果。当血细胞比容为 1%时,整个 SGB 的血浆撇取效率大于 95%。在所有血细胞比容条件下,SGB 内脊的效率都高于 80%。结果表明,设计的 SGB 成功地在脊间隙内诱导了出色的血浆撇取。这项研究首次提出并应用了一种形状设计策略,以在 SGB 内产生极佳的等离子撇取效果。这项研究可能有助于防止用于 RBP 的 SGB 内部发生溶血。
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引用次数: 0
A case of perioperative artificial pancreas therapy for a patient with esophageal cancer with type 1 diabetes. 食管癌合并1型糖尿病围手术期人工胰腺治疗1例。
IF 1.1 4区 医学 Q4 ENGINEERING, BIOMEDICAL Pub Date : 2024-09-01 Epub Date: 2023-11-29 DOI: 10.1007/s10047-023-01423-x
Hiroyuki Kitagawa, Keiichiro Yokota, Tsutomu Namikawa, Hiromichi Maeda, Michiya Kobayashi, Satoru Seo

A 72-year-old female with type 1 diabetes, a history of interstitial pneumonia, and diabetic ketoacidosis was admitted to our hospital with dysphagia. Endoscopy revealed a circumferential neoplastic lesion in the upper to middle esophagus, and a biopsy revealed squamous cell carcinoma. Computed tomography revealed invasion of the left main bronchus, and induction chemotherapy was initiated with a diagnosis of unresectable locally advanced esophageal cancer. After one course of induction chemotherapy, the tumor size reduced, bronchial invasion improved, and thoracoscopic esophagectomy was performed. During surgery and until 3 days after surgery, the patient's blood glucose level was controlled using an artificial pancreas, and the target blood glucose range was set at 140-180 mg/dL. On the fourth postoperative day, the patient was managed using a sliding scale. Mean blood glucose was 186.7 ± 70.0 mg/dL for 3 days before surgery, 190.5 ± 25.0 mg/dL during artificial pancreas therapy from the surgery to the next day, 169.8 ± 22.0 mg/dL during artificial pancreas therapy on the second to third postoperative days, and 174.5 ± 25.0 mg/dL during sliding scale therapy for 4-15 days after surgery. No hypoglycemia or ketoacidosis was noted.

一名72岁女性,1型糖尿病,间质性肺炎病史,糖尿病酮症酸中毒,因吞咽困难入院。内窥镜检查显示食管上部至中部有一环状肿瘤病变,活检显示鳞状细胞癌。计算机断层扫描显示左主支气管侵犯,诊断为不能切除的局部晚期食管癌,开始诱导化疗。诱导化疗1个疗程后肿瘤缩小,支气管侵犯改善,行胸腔镜食管切除术。术中至术后3天,采用人工胰腺控制患者血糖水平,目标血糖范围为140 ~ 180 mg/dL。术后第四天,采用滑动秤对患者进行管理。术前3天平均血糖为186.7±70.0 mg/dL,手术至次日人工胰腺治疗期间平均血糖为190.5±25.0 mg/dL,术后2 ~ 3天人工胰腺治疗期间平均血糖为169.8±22.0 mg/dL,术后4 ~ 15天滑动秤治疗期间平均血糖为174.5±25.0 mg/dL。无低血糖或酮症酸中毒。
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引用次数: 0
Abnormal stenosis of a drainage cannula due to excessive negative pressure during venovenous extracorporeal membrane oxygenation management: a case report. 静脉体外膜氧合管理过程中负压过大导致引流插管异常狭窄:病例报告。
IF 1.1 4区 医学 Q4 ENGINEERING, BIOMEDICAL Pub Date : 2024-09-01 Epub Date: 2023-08-05 DOI: 10.1007/s10047-023-01414-y
Tomoyuki Nakamura, Naohide Kuriyama, Yoshitaka Hara, Tomoaki Yamashiro, Satoshi Komatsu, Takahiro Kawaji, Seiko Hayakawa, Hidefumi Komura, Chizuru Yamashita, Osamu Nishida

We report a case in which excessive negative pressure may have been applied to the proximal side hole of a drainage cannula during venovenous extracorporeal membrane oxygenation (V-V ECMO), resulting in abnormal stenosis of the drainage cannula. V-V ECMO was introduced in a 71-year-old male patient who was transferred from another hospital for severe respiratory failure associated with varicella pneumonia and acute respiratory distress syndrome. Drainage was performed using a PCKC-V™ 24Fr (MERA, Japan) cannula via the right femoral vein with the tip of the cannula near the level of the diaphragm under fluoroscopy. Reinfusion was performed via the right internal jugular vein. Due to poor systemic oxygenation, the drainage cannula was withdrawn caudally and refixed to reduce the effect of recirculation. Two days later, drainage pressure dropped rapidly, and frequent ECMO flow interruption occurred due to poor drainage. An abdominal X-ray revealed abnormal stenosis of the proximal side hole site of the drainage cannula. We diagnosed that the drainage cannula was damaged, and it was replaced with another, namely a Medtronic Bio-Medicus™ 25 Fr (GETINGE, Sweden) cannula. However, the removed drainage cannula was not damaged, suggesting that the cannula was temporarily stenosed by momentary excessive negative pressure. In a multi-stage drainage cannula, the main drainage site is the proximal side hole, with little negative pressure applied at the apical foramen in a mock experimental ex vivo drainage test in a water tank. Hence, improvement of a multi-stage drainage cannula is recommended, such as adequate reinforcement of the side hole site with a wire.

我们报告了一个病例,其中静脉体外膜氧合(V-V ECMO)过程中可能对引流插管近侧孔施加了过多负压,导致引流插管异常狭窄。一名 71 岁的男性患者因水痘肺炎和急性呼吸窘迫综合征引起的严重呼吸衰竭而从另一家医院转入 V-V ECMO。在透视下,使用 PCKC-V™ 24Fr 插管(日本 MERA 公司)经右股静脉进行引流,插管尖端接近膈肌水平。通过右颈内静脉进行再输注。由于全身氧合不良,引流插管向尾部抽出并重新固定,以减少再循环的影响。两天后,引流压力急剧下降,由于引流不畅,ECMO 血流频繁中断。腹部 X 光片显示引流插管近侧孔部位异常狭窄。我们诊断引流插管已损坏,于是更换了另一根插管,即美敦力 Bio-Medicus™ 25 Fr 插管(GETINGE,瑞典)。然而,移除的引流套管并未损坏,这表明该套管因瞬间负压过大而暂时狭窄。在多级引流套管中,主要引流部位是近侧孔,在水箱中进行的模拟活体引流实验中,根尖孔处几乎没有负压。因此,建议对多级引流套管进行改进,例如用金属丝充分加固侧孔部位。
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引用次数: 0
Patient management important for long-term support beyond 5 years in the BTT: republication of the article published in the Japanese Journal of Artificial Organs. 患者管理对 BTT 5 年后的长期支持非常重要:重新发表在《日本人工器官杂志》上的文章。
IF 1.1 4区 医学 Q4 ENGINEERING, BIOMEDICAL Pub Date : 2024-09-01 Epub Date: 2024-03-29 DOI: 10.1007/s10047-024-01441-3
Masato Mutsuga

Heart transplantation is considered to be the best treatment for severe heart failure refractory to medical therapy, improving patients' survival and quality of life (QOL). However, the number of donors is smaller than the number of registered applicants for heart transplantation, which increases every year, and the waiting period for heart transplantation has been extended to more than 1700 days by 2022. Since 2011, reimbursement for the implantable left ventricular assist device (iLVAD) was established. The numbers of the iLVAD patients have been increasing year by year. Patients are managed at home with an iLVAD and can live with their families and even return to work, depending on the situation. On the other hand, self-management at home, including caregivers, is important for a safe life. Home management beyond 5 years is becoming more common due to long waiting time for transplant. This article outlines the important aspects of patient management for long-term support. This review was created based on a translation of the Japanese review written in the Japanese Journal of Artificial Organs in 2023 (Vol. 52, No. 1, pp. 62-66), with some modifications.

心脏移植被认为是药物治疗难治性严重心力衰竭的最佳治疗方法,可提高患者的生存率和生活质量(QOL)。然而,捐献者的数量少于心脏移植登记申请者的数量,而申请者的数量每年都在增加,到 2022 年,心脏移植的等待时间已延长至 1700 多天。自 2011 年起,开始对植入式左心室辅助装置(iLVAD)进行报销。iLVAD 患者人数逐年增加。患者通过 iLVAD 在家中接受管理,可以与家人一起生活,甚至视情况重返工作岗位。另一方面,包括护理人员在内的家庭自我管理对于安全生活也很重要。由于等待移植的时间较长,超过 5 年的家庭管理变得越来越普遍。本文概述了长期支持患者管理的重要方面。本综述是根据 2023 年《日本人工器官杂志》(第 52 卷,第 1 期,第 62-66 页)上的日文综述翻译而成,并做了一些修改。
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引用次数: 0
Rapid prototyping of multi-compartment models for urea kinetics in hemodialysis: a System Dynamics approach. 血液透析中尿素动力学多室模型的快速原型开发:一种系统动力学方法。
IF 1.1 4区 医学 Q4 ENGINEERING, BIOMEDICAL Pub Date : 2024-09-01 Epub Date: 2023-09-05 DOI: 10.1007/s10047-023-01416-w
David M Rubin, Robyn F R Letts, Xriz L Richards, Shamin Achari, Adam Pantanowitz

Models of urea kinetics facilitate a mechanistic understanding of urea transfer and provide a tool for optimizing dialysis efficacy. Dual-compartment models have largely replaced single-compartment models as they are able to accommodate the urea rebound on the cessation of dialysis. Modeling the kinetics of urea and other molecular species is frequently regarded as a rarefied academic exercise with little relevance at the bedside. We demonstrate the utility of System Dynamics in creating multi-compartment models of urea kinetics by developing a dual-compartment model that is efficient, intuitive, and widely accessible to a range of practitioners. Notwithstanding its simplicity, we show that the System Dynamics model compares favorably with the performance of a more complex volume-average model in terms of calibration to clinical data and parameter estimation. Its intuitive nature, ease of development/modification, and excellent performance with real-world data may make System Dynamics an invaluable tool in widening the accessibility of hemodialysis modeling.

尿素动力学模型有助于从机理上理解尿素转移,并为优化透析疗效提供了工具。双室模型已在很大程度上取代了单室模型,因为它们能够适应透析停止后的尿素反弹。尿素和其他分子物质的动力学建模经常被认为是高深莫测的学术活动,与床边工作关系不大。我们开发了一种高效、直观且广泛适用于各种从业人员的双室模型,证明了系统动力学在创建尿素动力学多室模型方面的实用性。尽管模型简单,但我们发现系统动力学模型在临床数据校准和参数估计方面的表现优于更复杂的容积平均模型。系统动力学模型的直观性、开发/修改的简便性以及在实际数据中的出色表现,可能会使其成为扩大血液透析模型使用范围的宝贵工具。
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引用次数: 0
Long-term results of hemi-resurfacing and metal-on-metal hip resurfacing for osteonecrosis of the femoral head. 半人工髋关节置换术和金属髋关节置换术治疗股骨头坏死的长期效果。
IF 1.1 4区 医学 Q4 ENGINEERING, BIOMEDICAL Pub Date : 2024-09-01 Epub Date: 2023-09-14 DOI: 10.1007/s10047-023-01417-9
Masahiro Hasegawa, Shine Tone, Yohei Naito, Hiroki Wakabayashi, Akihiro Sudo

Purpose: Hemi-resurfacing arthroplasty (Hemi) and metal-on-metal hip resurfacing arthroplasty (HR) were proposed as alternatives to conventional total hip arthroplasty (THA) for patients with osteonecrosis of the femoral head (ONFH). Long-term results were evaluated.

Methods: Twenty-three hips with ONFH were treated, using Hemi in 12 and HR in 11. Mean follow-up was 15 years in the Hemi group and 10 years in the HR group. Long-term outcomes were reviewed retrospectively.

Results: In the Hemi group, 8 hips showed acetabular protrusion and were revised to THA. One of the 8 hips showed femoral loosening. In the HR group, pseudotumor was detected in 4 hips (36%), and 1 hip was revised due to symptomatic pseudotumor. No evidence of any femoral or acetabular loosening was seen in the HR group. Ten-year survival rates were 64.2% and 90.9% in the Hemi and HR groups, respectively. Survival rate in the Hemi group dropped to 22.9% at 15 years.

Conclusions: Long-term results of Hemi for patients with ONFH were very poor, and Hemi should not continue to be used. Although HR had a concern of pseudotumor, it could offer attractive indications for 10 years.

目的:针对股骨头坏死(ONFH)患者,提出了半人工关节置换术(Hemi)和金属对金属髋关节置换术(HR)作为传统全髋关节置换术(THA)的替代方案。对长期结果进行了评估:共治疗了23例股骨头坏死患者,其中12例采用Hemi,11例采用HR。Hemi组平均随访15年,HR组平均随访10年。对长期结果进行了回顾性分析:结果:在Hemi组中,有8个髋关节出现髋臼突出,需要进行THA修复。8个髋关节中有1个出现股骨松动。在HR组中,4个髋关节(36%)发现假瘤,1个髋关节因有症状的假瘤进行了翻修。HR组未发现任何股骨或髋臼松动的证据。Hemi组和HR组的十年存活率分别为64.2%和90.9%。15年后,Hemi组的存活率降至22.9%:结论:Hemi治疗ONFH患者的长期效果很差,因此不应继续使用Hemi。虽然HR存在假瘤的隐患,但它可以在10年内提供有吸引力的适应症。
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引用次数: 0
Caregivers of patients with long-term implantable ventricular assist device: a republication of the article published in the Japanese Journal of Artificial Organs. 长期植入式心室辅助装置患者的护理人员:重新发表在《日本人工器官杂志》上的文章。
IF 1.1 4区 医学 Q4 ENGINEERING, BIOMEDICAL Pub Date : 2024-09-01 Epub Date: 2024-05-23 DOI: 10.1007/s10047-024-01445-z
Noriko Kikuchi

Implantable ventricular assist device (VAD) has enabled patients with severe heart failure to be discharged from the hospital and to continue their care at home. The presence of caregivers is essential to maintain home care of patients with VAD. The caregivers are mainly the family members who live with the patient with VAD. The caregivers need to be trained (1) VAD device management, (2) disinfection of driveline skin punctures, (3) medication management, and (4) responding to sudden changes. The caregivers' lifestyle is also forced to change. In this article, we discuss the role of caregivers in the VAD era, where long-term support beyond 5 years is now possible. This review was created based on a translation of the Japanese review written in the Japanese Journal of Artificial Organs in 2023 (Vol. 52, No. 1, pp. 81-84), with some modifications.

植入式心室辅助装置(VAD)使严重心力衰竭患者得以出院,并在家中继续接受护理。护理人员的存在对于维持 VAD 患者的家庭护理至关重要。护理人员主要是与 VAD 患者共同生活的家庭成员。护理人员需要接受以下方面的培训:(1) VAD 设备管理;(2) 干线皮肤穿刺消毒;(3) 药物管理;(4) 应对突变。护理人员的生活方式也被迫改变。在本文中,我们将讨论护理人员在 VAD 时代所扮演的角色,在这个时代,长期支持超过 5 年是可能的。本综述是根据 2023 年发表在《日本人工器官杂志》(第 52 卷第 1 期第 81-84 页)上的日文综述翻译而成,并做了一些修改。
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引用次数: 0
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Journal of Artificial Organs
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