体外膜氧化过程中c反应蛋白的动力学。

IF 1.4 4区 医学 Q4 ENGINEERING, BIOMEDICAL International Journal of Artificial Organs Pub Date : 2024-01-01 Epub Date: 2023-11-29 DOI:10.1177/03913988231213511
Yael Lichter, Amir Gal Oz, Uri Carmi, Nimrod Adi, Asaph Nini, Yoel Angel, Andrey Nevo, Daniel Aviram, Itay Moshkovits, Noam Goder, Dekel Stavi
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引用次数: 0

摘要

背景:体外膜氧合(ECMO)过程中,血液暴露于人工回路可诱导炎症反应。c反应蛋白(CRP)是一种常用的全身性炎症的生物标志物。方法:在这项回顾性观察性研究中,我们分析了110例经ECMO治疗的危重患者的每日血浆CRP测量结果。我们根据ECMO配置、2019冠状病毒病(COVID-19)状态和机械通气参数,比较不同组患者在ECMO手术前5天的CRP水平。结果:静脉-静脉(VV) ECMO前5天CRP水平下降有统计学意义(1-5天分别为173±111 mg/L、154±107 mg/L、127±97 mg/L、114±100 mg/L和118±90 mg/L, p p p = 0.126),计算MP变化无统计学意义(ECMO启动后3 h内从14.28±8.56 J/min降至10.81±8.09 J/min, p = 0.071)。结论:我们观察到在VV ECMO支持的前5天CRP水平显著下降,并提示伴随的通气MP降低可能减轻了肺泡应激和应变的程度,这可能有助于减少全身炎症过程。
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Kinetics of C-reactive protein during extracorporeal membrane oxygenation.

Background: The exposure of blood to the artificial circuit during extracorporeal membrane oxygenation (ECMO) can induce an inflammatory response. C-reactive protein (CRP) is a commonly used biomarker of systemic inflammation.

Methods: In this retrospective observational study, we analyzed results of daily plasma CRP measurements in 110 critically ill patients, treated with ECMO. We compared CRP levels during the first 5 days of ECMO operation, between different groups of patients according to ECMO configurations, Coronavirus disease 2019 (COVID-19) status, and mechanical ventilation parameters.

Results: There was a statistically significant decrease in CRP levels during the first 5 days of veno-venous (VV) ECMO (173 ± 111 mg/L, 154 ± 107 mg/L, 127 ± 97 mg/L, 114 ± 100 mg/L and 118 ± 90 mg/L for days 1-5 respectively, p < 0.001). Simultaneously, there was a significant reduction in ventilatory parameters, as represented by the mechanical power (MP) calculation, from 24.02 ± 14.53 J/min to 6.18 ± 4.22 J/min within 3 h of VV ECMO initiation (p < 0.001). There was non-significant trend of increase in CRP level during the first 5 days of veno arterial (VA) ECMO (123 ± 80 mg/L, 179 ± 91 mg/L, 203 ± 90 mg/L, 179 ± 95 mg/L and 198 ± 93 for days 1-5 respectively, p = 0.126) and no significant change in calculated MP (from 14.28 ± 8.56 J/min to 10.81 ± 8.09 J/min within 3 h if ECMO initiation, p = 0.071).

Conclusions: We observed a significant decrease in CRP levels during the first 5 days of VV ECMO support, and suggest that the concomitant reduction in ventilatory MP may have mitigated the degree of alveolar stress and strain that could have contributed to a decrease in the systemic inflammatory process.

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来源期刊
International Journal of Artificial Organs
International Journal of Artificial Organs 医学-工程:生物医学
CiteScore
3.40
自引率
5.90%
发文量
92
审稿时长
3 months
期刊介绍: The International Journal of Artificial Organs (IJAO) publishes peer-reviewed research and clinical, experimental and theoretical, contributions to the field of artificial, bioartificial and tissue-engineered organs. The mission of the IJAO is to foster the development and optimization of artificial, bioartificial and tissue-engineered organs, for implantation or use in procedures, to treat functional deficits of all human tissues and organs.
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