Analysis of early acute gastrointestinal injury and its influencing factors in patients with extracorporeal membrane oxygenation
Objective To investigate the acute gastrointestinal injury(AGI)in patients with extracorporeal membrane oxygenation(ECMO)at the early stage of operation and its influencing factors.Methods A total of 70 patients with ECMO who were hospitalized in the Emergency Care Unit of Guangxi Zhuang Autonomous Region People's Hospital from September 2020 to December 2021 were retrospectively analyzed,and a total of 70 patients with ECMO who were hospitalized in the emergency care unit of Guangxi Zhuang Autonomous Region People's Hospital from September 2020 to December 2021 were retrospectively analyzed.According to the 2012 guidelines of the European Society of Intensive Care Medicine on the classification of acute gastrointestinal injury in critically ill patients,the patients were divided into AG1 group and non-AGI group.The incidence of acute gastrointestinal injury in the early stage was statistically analyzed,and the results of blood gas analysis during ECMO loading and ECMO parameters,hemodynamic indexes and biochemical indexes after ECMO transfer were statistically analyzed.To explore the influencing factors and independent risk factors of AGI in the early stage.In addition,70 patients were divided into successful group and non-successful group according to whether they were successfully withdrawn.The occurrence of acute gastrointestinal injury between the two groups was compared,and the effect of acute gastrointestinal injury on ECMO patients was analyzed.Results Among the 70 ECMO patients,the incidence of early AGI was 71.43％(50 cases),and the components of AGI Ⅰ,Ⅱ,Ⅲ and Ⅳ were 18.57％(13 cases),41.43％(29 cases),11.43％(8 cases)and 0％(0 cases),respectively.① Univariate analysis showed that systolic blood pressure,diastolic blood pressure,mean arterial pressure(MAP),vasoactive drug index(VIS),pH,lactic acid and BMI were significantly different between AGI group and non-AGI group when ECMO was used(P＜0.05).Logistic binary regression analysis showed that BMI was an independent risk factor for early AGI in ECMO patients(ROC area 0.657,95％confidence interval 0.522-0.791(P＜0.05),and Yoden index 0.15).(3)The AGI composition ratio of the unsuccessful group was higher than that of the unsuccessful group(P＜0.05).Conclusions Patients with ECMO have a high incidence of AGI in the early stage,mainly occurring in grade Ⅰ and Ⅱ.Systolic blood pressure,diastolic blood pressure,MAP,VIS,pH,lactic acid and BMI when ECMO is put on are influential factors for the early development of AGI in ECMO patients,among which BMI is an independent risk factor for the early development of AGI in ECMO patients.The occurrence of AGI reduces the probability of successful withdrawal in ECMO patients.
Extracorporeal membrane oxygenationAcute gastrointestinal injuryBlood perfusionBMIVasoactive drug indexLactic acidInfluencing factorsprognosis
万方数据
维普
