关于:在常规心肺复苏术中启动体外膜肺氧合的时间会影响患者的生存预后。

IF 9 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL Journal of Internal Medicine Pub Date : 2024-10-23 DOI:10.1111/joim.20020
Zegang Ruan, Yuhao Gan, Chenyang Xu
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引用次数: 0

摘要

亲爱的编辑,我们饶有兴趣地阅读了 Sim 等人发表在《内科学杂志》上的文章[1]。作者进行了一项涉及 198 名患者的回顾性研究,探讨了常规心肺复苏(CPR)过程中体外膜肺氧合(ECMO)启动时机对患者存活预后的影响。研究结果强调了 ECMO 在常规心肺复苏中的关键作用,尤其突出了尽早启动 ECMO 能显著提高患者的生存预后。我们对作者在临床实践中优化 ECMO 启动时机的做法表示赞赏。首先,文章选择性地分析了接受 ECMO 的患者,但没有提供有关排除和选择标准的详细信息。例如,文章没有明确解释如何管理合并症严重或死亡风险较高的患者。其次,文章对患者神经系统预后的描述不够充分,没有包括患者出院后(3 个月或 6 个月后)神经系统长期预后的数据。鉴于心脏骤停后神经功能的恢复可能需要较长的时间[2],这一局限性妨碍了对患者长期预后的全面了解。第三,尽管文章重点关注 ECMO 的启动时机,但并未分析与 ECMO 相比的其他并发治疗(如高质量心肺复苏、药物和体温管理)。总之,我们感谢作者强调在心肺复苏期间及时启动 ECMO 对提高患者存活率的重要意义。这项工作将提高医护人员对早期启动 ECMO 关键重要性的认识,并促进该领域的快速发展:方法学;写作-原稿;调查。甘宇豪方法学;写作-原稿;调查。徐晨阳作者声明无利益冲突。
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Regarding: Time to initiation of extracorporeal membrane oxygenation in conventional cardiopulmonary resuscitation affects the patient survival prognosis

Dear Editor,

We read with great interest the article by Sim et al. [1] published in the Journal of Internal Medicine. The authors conducted a retrospective study involving 198 patients to examine the impact of extracorporeal membrane oxygenation (ECMO) initiation timing during routine cardiopulmonary resuscitation (CPR) on patient survival prognosis. The study's findings underscore the crucial role of ECMO in routine CPR, particularly highlighting that an early initiation of ECMO significantly enhances patient survival outcomes. We commend the authors for optimizing the timing of ECMO initiation in clinical practice. However, several aspects warrant further discussion.

First, the article selectively analysed patients who received ECMO but did not provide detailed information regarding the exclusion and selection criteria. For instance, there is no clear explanation of how patients with severe comorbidities or a higher risk of death were managed. This omission could result in a non-representative sample, potentially affecting the generalizability of the study's conclusions.

Second, the article inadequately addresses the neurological prognosis of the patients, as it fails to include data on their long-term neurological outcomes post-discharge (after 3 or 6 months). Given that neurological recovery following cardiac arrest may take an extended period [2], this limitation hinders a comprehensive understanding of the patient's long-term prognosis.

Third, although the article focuses on the timing of ECMO initiation, it does not analyse other concurrent treatments (e.g., high-quality CPR, medications, and temperature management) compared to ECMO. This omission prevents a clear delineation of ECMO's unique contribution relative to other interventions throughout the treatment process [3].

In conclusion, we appreciate the authors for highlighting the significance of timely ECMO initiation during CPR to improve patient survival. This work will raise healthcare professionals’ awareness of the critical importance of early ECMO initiation and contribute to the rapid advancement of this field.

Zegang Ruan: Methodology; writing—original draft; investigation. Yuhao Gan: Methodology; writing—original draft; investigation. Chenyang Xu: Writing—review and editing; supervision.

The authors declare no conflicts of interest.

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来源期刊
Journal of Internal Medicine
Journal of Internal Medicine 医学-医学:内科
CiteScore
22.00
自引率
0.90%
发文量
176
审稿时长
4-8 weeks
期刊介绍: JIM – The Journal of Internal Medicine, in continuous publication since 1863, is an international, peer-reviewed scientific journal. It publishes original work in clinical science, spanning from bench to bedside, encompassing a wide range of internal medicine and its subspecialties. JIM showcases original articles, reviews, brief reports, and research letters in the field of internal medicine.
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