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成人心脏术后心源性休克患者接受体外膜肺氧合辅助的临床结果荟萃分析

邵程程 王粮山 王红 侯晓彤

中国体外循环杂志2019,Vol.17Issue(1):4-7,25,5.
中国体外循环杂志2019,Vol.17Issue(1):4-7,25,5.DOI:10.13498/j.cnki.chin.j.ecc.2019.01.02

成人心脏术后心源性休克患者接受体外膜肺氧合辅助的临床结果荟萃分析

Clinical outcomes of adults with postcardiotomy cardiogenic shock undergoing venoarterial extracorporeal membrane oxygenation: A systematic review and meta-analysis

邵程程 1王粮山 1王红 1侯晓彤1

作者信息

  • 1. 首都医科大学附属北京安贞医院心脏外科危重症中心 100029 北京
  • 折叠

摘要

Abstract

Objective This study was designed to investigate the clinical outcomes of adults with postcardiotomy cardiogenic shock undergoing venoarterial extracorporeal membrane oxygenation. Methods We searched PubMed, Embase, Cochrane Library and other databases to find out relevant studies of postoperative ECMO patients for meta-analysis. Results Fourteen observational studies were selected for final analysis. The pooled mortality rate to hospital discharge was 66.0% (95% CI 0.61, 0.71) in PCS patients receiving ECMO. The pooled 1-year survival rate was 24% (95% CI 0.19, 0.30). The pooled midterm survival rate was 19% (95% CI0.10, 0.34). The pooled rate of lower limb ischemia was 14% (95% CI 0.10, 0.20). The pooled rate of reoperation was 44% (95%CI 0.21, 0.70). The pooled rate of renal failure was 49% (95% CI 0.38, 0.61). The pooled rate of neurologic complications was 18% (95% CI 0.11, 0.29). The pooled rate of infection was 23% (95% CI 0.16, 0.31). Most of the included studies commonly revealed that age>65 years, pre-ECMO or post-ECMO blood lactate, renal insufficiency, long duration of ECMO, and neurologic complications were risk factors of in-hospital mortality in PCS patients undergoing ECMO. Conclusion The short-term and midterm survival rates of PCS patients treated with ECMO were relatively low, and post-ECMO complication rates were relatively high. Many risk factors were related to in-hospital mortality.

关键词

体外膜肺氧合/心脏术后心源性休克/死亡率/并发症/危险因素/荟萃分析/评价/临床结果

Key words

Extracorporeal membrane oxygenation/Postcardiotomy cardiogenic shock/Mortality rate/Complication/Risk factor/Meta-analysis/Evaluate/Clinical outcome

引用本文复制引用

邵程程,王粮山,王红,侯晓彤..成人心脏术后心源性休克患者接受体外膜肺氧合辅助的临床结果荟萃分析[J].中国体外循环杂志,2019,17(1):4-7,25,5.

基金项目

国家重点研发计划 (2016YFC1301001) (2016YFC1301001)

中国体外循环杂志

OACSTPCD

1672-1403

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