背景:SARS-CoV-2大流行导致物资短缺,这限制了体外膜氧合(ECMO)支持的使用。作为一种应急策略,使用聚丙烯(PP)氧合膜。这项研究描述了与聚甲基戊烯(PMP)氧合膜相比,使用PP的ECMO患者的临床结果。
方法:对2020年至2021年接受ECMO支持的患者进行回顾性队列研究。
结果:共纳入152例接受ECMO支持的患者,71.05%为男性,平均年龄为42(SD9.91)岁。75.6%的病例进行了静脉-静脉配置。PP氧合膜需要更多的变化22(63.1%),比PMPSorin®24(32,8%)和Euroset®15(31,9%)(p.0.022)。膜变化的主要指示是PP的低氧转移为56.2%,Sorin®50%,和Euroset®为14.8%。肾脏替代疗法是22例患者(68.7%)中最常见的PP膜并发症,Sorin®25例患者(34.2%),和Euroset®15患者(31.9%)(p<0.001)死亡率无统计学显著差异。
结论:PP氧合膜是一种有用且可行的策略。在SARS-CoV-2大流行期间,在严重逆境的情况下,ECMO对危重病的支持更大。
BACKGROUND: The SARS-CoV-2 pandemic resulted in shortages of supplies, which limited the use of extracorporeal membrane oxygenation (ECMO) support. As a contingency strategy, polypropylene (PP) oxygenation membranes were used. This study describes the clinical outcomes in patients on ECMO with PP compared to poly-methylpentene (PMP) oxygenation membranes.
METHODS: Retrospective cohort of patients in ECMO support admitted between 2020 and 2021.
RESULTS: A total of 152 patients with ECMO support were included, 71.05% were men with an average age of 42 (SD 9.91) years. Veno-venous configuration was performed in 75.6% of cases. The PP oxygenation membranes required more changes 22 (63.1%), than the PMP Sorin® 24 (32,8%) and Euroset® 15 (31,9%) (p.0.022). The main indication for membrane change was low oxygen transfer for PP at 56.2%, Sorin® at 50%, and Euroset® at 14.8%. Renal replacement therapy was the most frequent complication with PP membrane in 22 patients (68.7%) Sorin® 25 patients (34.2%), and Euroset® 15 patients (31.9%) (p 0.001) without statistically significant differences in mortality.
CONCLUSIONS: PP oxygenation membranes was a useful and feasible strategy. It allowed a greater disponibility of ECMO support for critically ill in a situation of great adversity during the SARS-CoV-2 pandemic.