Utilization of Cardiopulmonary Bypass in Trauma Patients: A Multi-Institutional Study of the American Association for the Surgery of Trauma.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Karamchandani Manish M, Nahmias Jeffry, Alvarez Claudia, Callcut Rachael A, Stadeli Kathryn M, Park Caroline, Kost Melissa, Bruce Nolan, Biffl Walter L, Al-Dulaimi Hiba, Wood Frank C, Gushing Jonathan D, Taghavi Sharven, Ghio Michael, Kirsch Jordan M, Staszak Jessica K, Collier Bryan, Jordan Marcy Bubar, Sciarretta Jason D, Chow Kevin, Evans David C, Rady Emily W, Mukherjee Kaushik, Winchell Robert J, Hsu Chun Yun, Brasel Karen, Henry Reynold, Doles Bethany, Smith Brennan, Williams Judson B, Udekwu Pascal O, Bhattacharya Bishwajit, Jones Tyler, Byrne James, Haut Elliott, Jacobson Lewis E, Williams Jamie M, Brat Gabriel, Beaulieu-Jones Brendin R, Harfouche Melike N, Rao Appajosula S, Bauman Zachary M, Goodman Michael, Craugh Lauren, Winfield Robert D, Rakhit Shayan, Maiga Amelia W, Blay Eddie, Fernández Luis G, Pero Brandi, Brown Carlos V R, Weresh Henry, Wilson Chad T, Miles Travis J, Barmparas Galinos, Margulies Daniel R, Ra Jin, O'Keeffe Terence, Fickle Jay, Draper Brian, Barbosa Ron, Bugaev Nikolay
Аннотация
BackgroundThe purpose of this descriptive study was to characterize the utilization and outcomes of CPB after trauma.MethodsThis is an AAST-sponsored retrospective (2011-2021) multicenter (32 centers) study of all adult trauma patients undergoing CPB. Univariate analysis comparing demographics, clinical characteristics and the study outcomes were performed between those who required CPB≤2 hours, >2-24 hours, and >24 hours from the arrival. The primary outcome was mortality.ResultsThere were 113 patients, 63% sustained blunt trauma. The most common injuries were cardiac (42%), thoracic aorta (42%), and pericardial tamponade (25%). The three most common reasons to use CPB were aortic repair (32%), cardiopulmonary resuscitation (20%), and cardiac repair (15%). CPB was performed within 2 hours in 44(39%), and 21(19%) underwent CPB after 24-hours. Penetrating mechanisms of injury 24 (55%) (P = .009), higher rate of hypotension (SBP <80 mmHg) 15 (71%) (P = .002) were more common in CPB≤2-hours. Septal (P = .001) and valvular (P = .002) injuries were more frequent in CPB >24 hours, otherwise there were no differences in injury patterns among CPB ≤2 hours, >2-24 hours, and >24 hours. Cardiac repair was the most common indications for CPB ≤2 hours (P = .002), aorta repair was more common in CPB 2-24 hours (P = .03). Complications were not different between CPB ≤2 hours, >2-24 hours, and >24 hours. Among survivors, no differences in terms of discharge disposition, hospital LOS were found (all P > .05). Mortality was 22% with 96% of them undergoing CPB in the first 24 hours (P < .001).ConclusionsCPB is rarely used for traumatic injuries. The true impact of CPB is unknown and should be studied in comparison to patients with cardiovascular injuries that are repaired without CPB.Level of EvidenceLevel IV; Therapeutic/Care Management.