心源性休克患者单用 ECMO 与 ECPELLA 的对比:多中心 EVACS 研究。

IF 3.1 3区 医学 Q2 ENGINEERING, BIOMEDICAL ASAIO Journal Pub Date : 2024-11-01 Epub Date: 2024-05-03 DOI:10.1097/MAT.0000000000002219
Antonio Piperata, Jef Van den Eynde, Charles-Henri David, Ahmet Ruchan Akar, Masazumi Watanabe, Ilias Doulamis, Pierre-Guillaume Piriou, Mehmet Cahit Saricaoğlu, Hiroki Ikenaga, Thomas Gouttenegre, Mickael Vourc'h, Shinya Takahashi, Alexandre Ouattara, Louis Labrousse, Giacomo Frati, Mathieu Pernot
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引用次数: 0

摘要

该研究旨在探讨静脉体外膜肺氧合(ECMO)与 Impella 左心室减压术(ECPELLA)并用治疗心源性休克患者的效果,并与单独使用 ECMO 的效果进行比较。研究分析了来自 4 个国际中心需要机械循环支持的患者的数据。在纳入的 438 名患者中,分别有 319 人(72.8%)和 119 人(27.2%)采用了单纯 ECMO 和 ECPELLA。倾向评分匹配分析确定了 95 对患者。在匹配队列中,ECMO 和 ECPELLA 的 30 天死亡率分别为 49.5% 和 43.2% ( P = 0.467)。两组的并发症发生率差异不大(分别为 P = 0.877、P = 0.629、P = 1.000)。中位随访 0.18 年(四分位间范围 0.02-2.55)后,与单纯 ECMO 相比,使用 ECPELLA 的死亡率相似(危险比 0.81,95% 置信区间 0.54-1.20,P = 0.285),ECPELLA 和单纯 ECMO 的 1 年总生存率分别为 51.3% 和 46.6%。对于需要机械循环支持治疗心源性休克的患者来说,单纯 ECMO 和 ECPELLA 都是有效的策略,两者的早期和中期存活率相似。
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ECMO Alone Versus ECPELLA in Patients Affected by Cardiogenic Shock: The Multicenter EVACS Study.

The objective was to investigate the outcomes of concomitant venoarterial extracorporeal membrane oxygenation (ECMO) and left ventricular unloading with Impella (ECPELLA) compared with ECMO alone to treat patients affected by cardiogenic shock. Data from patients needing mechanical circulatory support from 4 international centers were analyzed. Of 438 patients included, ECMO alone and ECPELLA were adopted in 319 (72.8%) and 119 (27.2%) patients, respectively. Propensity score matching analysis identified 95 pairs. In the matched cohort, 30-day mortality rates in the ECMO and ECPELLA were 49.5% and 43.2% ( P = 0.467). The incidences of complications did not differ significantly between groups ( P = 0.877, P = 0.629, P = 1.000, respectively). After a median follow-up of 0.18 years (interquartile range 0.02-2.55), the use of ECPELLA was associated with similar mortality compared with ECMO alone (hazard ratio 0.81, 95% confidence interval 0.54-1.20, P = 0.285), with 1-year overall survival rates of 51.3% and 46.6%, for ECPELLA and ECMO alone, respectively. ECMO alone and ECPELLA are both effective strategies in patients needing mechanical circulatory support for cardiogenic shock, showing similar rates of early and mid-term survival.

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来源期刊
ASAIO Journal
ASAIO Journal 医学-工程:生物医学
CiteScore
6.60
自引率
7.10%
发文量
651
审稿时长
4-8 weeks
期刊介绍: ASAIO Journal is in the forefront of artificial organ research and development. On the cutting edge of innovative technology, it features peer-reviewed articles of the highest quality that describe research, development, the most recent advances in the design of artificial organ devices and findings from initial testing. Bimonthly, the ASAIO Journal features state-of-the-art investigations, laboratory and clinical trials, and discussions and opinions from experts around the world. The official publication of the American Society for Artificial Internal Organs.
期刊最新文献
Impella as Bridge to Durable Left Ventricular Assist Device in Acute Myocardial Infarction Cardiogenic Shock Patients. Volume Displacement Pulsatile Veno-Arterial Extracorporeal Membrane Oxygenation: Preliminary Data From In Vitro Tests. ECMO Alone Versus ECPELLA in Patients Affected by Cardiogenic Shock: The Multicenter EVACS Study. Three-Dimensional Bio-Printed Tubular Tissue Using Dermal Fibroblast Cells as a New Tissue-Engineered Vascular Graft for Venous Replacement. Comparison of Weaning Strategies in Patients Receiving Venovenous Extracorporeal Membrane Oxygenation: An Exploratory Retrospective Study.
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