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体外膜肺氧合在心肌梗死相关性心源性休克中的应用:血液生物标志物作为死亡率的预测指标

ECMO in Myocardial Infarction-Associated Cardiogenic Shock: Blood Biomarkers as Predictors of Mortality.

作者信息

Senoner Thomas, Treml Benedikt, Breitkopf Robert, Oezpeker Ulvi Cenk, Innerhofer Nicole, Eckhardt Christine, Spurnic Aleksandra Radovanovic, Rajsic Sasa

机构信息

Department of Anesthesiology and Intensive Care Medicine, Medical University Innsbruck, 6020 Innsbruck, Austria.

Department of Cardiac Surgery, Medical University Innsbruck, 6020 Innsbruck, Austria.

出版信息

Diagnostics (Basel). 2023 Dec 17;13(24):3683. doi: 10.3390/diagnostics13243683.

Abstract

BACKGROUND

Veno-arterial extracorporeal membrane oxygenation (va-ECMO) can provide circulatory and respiratory support in patients with cardiogenic shock. The main aim of this work was to investigate the association of blood biomarkers with mortality in patients with myocardial infarction needing va-ECMO support.

METHODS

We retrospectively analyzed electronic medical charts from patients receiving va-ECMO support in the period from 2008 to 2021 at the Medical University Innsbruck, Department of Anesthesiology and Intensive Care Medicine.

RESULTS

Of 188 patients, 57% (108/188) survived to discharge, with hemorrhage (46%) and thrombosis (27%) as the most frequent adverse events. Procalcitonin levels were markedly higher in non-survivors compared with survivors during the observation period. The multivariable model identified higher blood levels of procalcitonin (HR 1.01, = 0.002) as a laboratory parameter associated with a higher risk of mortality.

CONCLUSIONS

In our study population of patients with myocardial infarction-associated cardiogenic shock, deceased patients had increased levels of inflammatory blood biomarkers throughout the whole study period. Increased procalcitonin levels have been associated with a higher risk of mortality. Future studies are needed to show the role of procalcitonin in patients receiving ECMO support.

摘要

背景

静脉-动脉体外膜肺氧合(va-ECMO)可为心源性休克患者提供循环和呼吸支持。本研究的主要目的是探讨血液生物标志物与需要va-ECMO支持的心肌梗死患者死亡率之间的关联。

方法

我们回顾性分析了2008年至2021年期间在因斯布鲁克医科大学麻醉学与重症医学科接受va-ECMO支持的患者的电子病历。

结果

188例患者中,57%(108/188)存活至出院,出血(46%)和血栓形成(27%)是最常见的不良事件。在观察期内,非存活者的降钙素原水平明显高于存活者。多变量模型确定较高的降钙素原血水平(HR 1.01, = 0.002)是与较高死亡风险相关的实验室参数。

结论

在我们的心肌梗死相关性心源性休克患者研究人群中,死亡患者在整个研究期间炎症血液生物标志物水平升高。降钙素原水平升高与较高的死亡风险相关。未来需要开展研究以阐明降钙素原在接受ECMO支持患者中的作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e258/10742636/f1568e56b0f1/diagnostics-13-03683-g001.jpg

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