体外膜肺氧合辅助体外心肺复苏患者复苏失败因素分析  

Analysis of resuscitation failure factors in patients with extracorporeal membrane oxygenation assisted cardiopulmonary resuscitation

作　　者：付婧[1] 石岩[1] 杨海晨[1] 赵志坤 杜叶平[1] FU Jing;SHI Yan;YANG Haichen;ZHAO Zhikun;DU Yeping(ICU,Second Hospital of Huai'an City,Huai'an Jiangsu 223001,China)

机构地区：[1]淮安市第二人民医院ICU,江苏淮安223001

出　　处：《中国急救复苏与灾害医学杂志》2022年第8期1025-1028,共4页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：江苏省卫生健康委员会2017年高层次卫生人才“六个一工程”拔尖项目(编号:LGY2017014);宿迁市科技局项目(编号:S201914)。

摘　　要：目的分析体外膜肺氧合辅助体外心肺复苏(ECPR)患者复苏失败因素。方法回顾性分析2017年4月—2021年6月淮安市第二人民医院收治的41例心脏骤停并实施体ECPR患者的临床资料,统计复苏失败发生情况,并依据是否复苏成功分为成功组和失败组。对比成功组和失败组患者临床资料。Logistic回归分析探讨影响心脏搏停ECPR患者复苏失败的相关因素。结果ECPR患者复苏失败的发生率为43.90%。失败组院外心脏骤停占比、心脏停搏持续时间、常规复苏至体外膜肺氧合创建完成时间、体外膜肺氧运行时间、序贯器官衰竭估计(SOFA)评分均高于成功组(P<0.05)。Logistic回归分析结果显示,院外心脏骤停、心脏停博持续时间及常规复苏至体外膜肺氧合创建完成时间均为影响体ECPR患者复苏失败的危险因素(OR=2.7352、3.323、2.78,P<0.05)。结论院外心脏骤停、心脏停搏持续时间及常规复苏至体外膜肺氧合创建完成时间均为影响ECPR患者复苏失败的危险因素。Objective To analyze the factors of failure of resuscitation in patients with extracorporeal membrane oxygenation assisted extracorporeal cardiopulmonary resuscitation(ECPR).Methods A retrospective analysis of the clinical data of 41 patients undergoing cardiac arrest and ECPR with extracorporeal membrane oxygenation assisted by ECPR admitted to the Second People's Hospital of Huai'an from April 2017 to June 2021 was retrospectively analyzed,and the occurrence of resuscitation failure was counted and based on whether resuscitation was performed.Success is divided into success group and failure group.The clinical data of patients in the success group and the failure group were compared.Logistic regression analysis was used to explore the influencing factors.Results The incidence of resuscitation failure in ECPR patients was 43.90%.The proportion of out-of-hospital cardiac arrest,the duration of cardiac arrest,the completion time from routine resuscitation to the creation of extracorporeal membrane oxygenation,the running time of extracorporeal membrane oxygenation,and the Sequential Organ Failure Estimation(SOFA)score in the failure group were higher than those in the successful group(P<0.05).Logistic regression analysis showed that out-of-hospital cardiac arrest,duration of cardiac arrest,and time from routine resuscitation to completion of extracorporeal membrane oxygenation were all risk factors for resuscitation failure in patients with cardiac arrest in vivo ECPR(OR=2.7352,3.323,2.78,P<0.05).Conclusion Out-of-hospital cardiac arrest,duration of cardiac arrest,and time from routine resuscitation to completion of extracorporeal membrane oxygenation were all risk factors for resuscitation failure in ECPR cardiac arrest patients.Conclusion Out-of-hospital cardiac arrest,duration of cardiac arrest,and time from routine resuscitation to completion of extracorporeal membrane oxygenation were all risk factors for resuscitation failure in ECPR cardiac arrest patients.

关 键 词：心脏骤停 体外膜肺氧合 心肺复苏 危险因素 

分 类 号：R541[医药卫生—心血管疾病]