静脉-动脉体外膜氧合与静脉-静脉体外膜氧合治疗重症患者死亡病例的回顾性分析OA

Objective To compare the clinical characteristics of patients who died on veno-arterial extracorporeal membrane oxygenation(V-A ECMO)versus veno-venous extracorporeal membrane oxygenation(V-V ECMO)support,in order to provide clinical references for optimizing ECMO treatment strategies and reducing mortality in critically ill patients.Methods A retrospective analysis was performed on the clinical data of 59 patients who died during ECMO support at Anhui Provincial Hospital.According to the support mode,patients were divided into a V-A ECMO group(n=41)and a V-V ECMO group(n=18).Baseline data,incidence of complications,duration of ECMO support,and direct causes of death were collected and compared between the two groups.Results No significant differences were observed between the two groups regarding pa-tient age,gender,or major comorbidities.Analysis of complications revealed that bleeding complications were the most common overall(52.54%),while lower limb ischemia complications were observed only in the V-A ECMO group(19.51%).Both hospital length of stay and duration of ECMO support were significantly longer in the V-V ECMO group compared to those in the V-A ECMO group(P<0.05).Regarding direct causes of death,patients in the V-A ECMO group predominantly died of cardiogenic shock(41.46%),whereas patients in the V-V ECMO group mainly died of septic shock(44.44%).Conclusion Baseline clinical characteristics showed no significant differences between patients who died after VA-ECMO and VV-ECMO therapy.However,distinct differences existed between the two groups in terms of ECMO treatment duration and primary direct causes of death.It is necessary to optimize ECMO support strategies based on patient etiology and enhance the prevention and management of com-plications to improve the prognosis of critically ill patients.