Influencing factors and coping strategies of bad prognosis of explosive myocarditis during ECMO treatment
[Objective]To analyze the risk factors of adverse prognosis during the treatment of explosive myocarditis with ECMO,and explore specific coping strategies.[Methods]This is a retrospective study.The case was included from January 2021 to January 2023.The study object was 70 patients with explosive myocarditis.All patients received ECMO treatment.According to the treatment,28 patients with adverse prognosis during treatment were classified as high-risk group,and 42 patients without adverse prognosis were classified as control group.General data and clinical data of the two groups were collected and compared.Logistic multivariate regression analysis summarized the risk factors that can lead to poor prognosis during ECMO treatment in patients,and combined the analysis results to explore specific coping strategies.[Results]The results of statistical univariate analysis showed that there were certain differences in gender,age,comorbidities,basic physical signs at admission,blood indicators,heart function,myocardial function,and treatment status between the two groups of patients(P＜0.05).The results of logistic multiple factor regression analysis showed that patients with cerebral hemorrhage,gastrointestinal diseases,multiple organ failure,RR ≥20 times/min,SBP ≤90 mmHg,DBP ≤60 mmHg,and WBC ≥10×109 L at admission,NE ≥70％,LVEF ≤40％,QRS interval＞120 ms,PR interval＞178 ms,LDH level ≥37 U/L,CK-MB ≥23 U/L,cTn Ⅰ ≥18 ng/mL,implementation of IABP treatment,implementation of ventilator assistance,application of β receptor blockers and the use of positive inotropic drugs are risk factors for poor prognosis during ECMO treatment.[Conclusion]Merge multiple underlying diseases,abnormal physical signs upon admission,concurrent infection symptoms,presence of cardiac function,myocardial dysfunction,implementation of IABP therapy,and application of ventilator assistance,β receptor blockers or positive inotropic agents are risk factors for adverse prognosis during ECMO treatment of explosive myocarditis.Comprehensive assessment of patients'physical conditions,correction of basic signs,active treatment of primary diseases,improvement of cardiac function and myocardial function,and careful use of IABP,respirator or related drugs are important measures to improve the safety of ECMO treatment.
万方数据
维普
