弥散性血管内凝血与院外心脏骤停患者接受VA-ECMO的不良预后相关。

IF 1.1 4区 医学 Q4 ENGINEERING, BIOMEDICAL Journal of Artificial Organs Pub Date : 2025-01-06 DOI:10.1007/s10047-024-01487-3
Satoshi Gando, Takumi Tsuchida, Takeshi Wada
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引用次数: 0

摘要

我们检验了弥散性血管内凝血(DIC)预测院外心脏骤停(OHCA)患者接受静脉-动脉体外膜氧合(VA-ECMO)治疗预后不良的假设。57例心源性OHCA患者入急诊科后立即行VA-ECMO,分为非DIC患者27例和DIC患者30例。入院时和24 h后(第1天)计算DIC评分。主要结局指标为全因住院死亡率。两组患者的基本特征无差异;然而,DIC患者的住院死亡率更高。受试者工作特征曲线分析显示,第1天DIC评分对院内死亡率有中等预测能力。DIC患者的生存率较低。院内死亡第1天DIC的校正优势比为5.67,校正风险比为3.472。结果表明,VA-ECMO诱导OHCA后24小时DIC诊断与这些患者预后不良有关。
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Disseminated intravascular coagulation is associated with a poor outcome in patients with out-of-hospital cardiac arrest receiving VA-ECMO.

We tested the hypothesis that disseminated intravascular coagulation (DIC) predicts a poor prognosis in patients with out-of-hospital cardiac arrest (OHCA) treated with veno-arterial extracorporeal membrane oxygenation (VA-ECMO). Fifty-seven patients with cardiogenic OHCA who immediately underwent VA-ECMO upon admission to the emergency department were divided into 27 non-DIC and 30 DIC patients. DIC scores were calculated on admission and 24 h later (day 1). The primary outcome measure was the all-cause in-hospital mortality. The basic characteristics did not differ between the two groups; however, patients with DIC showed higher in-hospital mortality rates. Receiver operating characteristic curve analysis showed a moderate predictive ability of DIC scores on day 1 for in-hospital mortality. A lower probability of survival was observed in patients with DIC. The adjusted odds ratio for DIC on day 1 of in-hospital death was 5.67, confirmed by the adjusted hazard ratio of 3.472. The results indicate an association between DIC diagnosis 24 h following VA-ECMO induction for OHCA and poor outcome in these patients.

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来源期刊
Journal of Artificial Organs
Journal of Artificial Organs 医学-工程:生物医学
CiteScore
2.80
自引率
15.40%
发文量
68
审稿时长
6-12 weeks
期刊介绍: The aim of the Journal of Artificial Organs is to introduce to colleagues worldwide a broad spectrum of important new achievements in the field of artificial organs, ranging from fundamental research to clinical applications. The scope of the Journal of Artificial Organs encompasses but is not restricted to blood purification, cardiovascular intervention, biomaterials, and artificial metabolic organs. Additionally, the journal will cover technical and industrial innovations. Membership in the Japanese Society for Artificial Organs is not a prerequisite for submission.
期刊最新文献
Learning from history to improve the performance of blood purification devices and dialysis membranes: from engineering points of view. Barriers and solutions for introducing donation after circulatory death (DCD) in Japan. Incidence of neutrophil extracellular traps (NETs) in different membrane oxygenators: pilot in vitro experiments in commercially available coated membranes. Progress of extracorporeal centrifugal pumps for mechanical circulatory supports. Disseminated intravascular coagulation is associated with a poor outcome in patients with out-of-hospital cardiac arrest receiving VA-ECMO.
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