简介：AbstractBackground:Intracerebral hemorrhage (ICH) is one of the most severe complications during veno-venous extracorporeal membrane oxygenation (VV-ECMO). This study aimed to determine the risk factors for ICH and mortality in such patients.Methods:We analyzed the clinical data of 77 patients who received VV-ECMO due to severe respiratory failure from July 2013 to May 2019 at China-Japan Friendship Hospital. Demographical data, laboratory indices, imaging characteristics, and other clinical information were collected. Multivariable logistic regression analyses were performed to identify risk factors for ICH and mortality.Results:Of 77 patients, 11 (14.3%) suffered from ICH, and 36 (46.8%) survived. The survival rate was significantly lower (18.2% [2/11] vs. 51.5% [34/66], P = 0.040) in patients with ICH than in those without ICH. Multivariable analysis revealed that factors independently associated with ICH were diabetes mellitus (adjusted odds ratio [aOR]: 12.848, 95% confidence interval [CI]: 1.129-146.188, P = 0.040) and minimum fibrinogen during ECMO (aOR: 2.557, 95% CI: 1.244-5.252, P = 0.011). Multivariable analysis showed that factors independently associated with mortality were acute hepatic failure during ECMO (aOR: 9.205, 95% CI: 1.375-61.604, P = 0.022), CO2 retention before ECMO (aOR: 7.602, 95% CI: 1.514-38.188, P = 0.014), and minimum platelet concentration during ECMO (aOR: 0.130, 95% CI: 0.029-0.577, P = 0.007).Conclusions:Diabetes mellitus and minimum fibrinogen concentration during ECMO are risk factors for ICH in patients with severe respiratory failure managed using VV-ECMO. This indicated that anticoagulants use and nervous system monitoring should be performed more carefully in patients with diabetes when treated with VV-ECMO due to severe respiratory failure.

简介：【摘要】目的 分析体外膜肺氧合(ECMO)相关医院感染患者的临床特征及危险因素。方法 回顾性分析本院2017年3月-2021年11月期间收治的21例行体外膜肺氧合治疗患者进行研究，分析并总结感染的临床特征和危险因素。结果  出现感染症状8例（38.09%），未感染13例（61.90%） ；感染呼吸道4例（50.00%）、感染血液系统2例（25.00%）、感染皮肤和软组织2例（25.00%）；病原体分离出来12株，7株革兰阴性杆菌占比58.33%、3株革兰阳性球菌占比25.00%，2株真菌占比16.66%；5株来自痰标本占比41.66%、4株来自血液标本占比33.33%、3株来自伤口分泌物标本占比25.00%。导致患者出现医院感染的危险因素有：年龄、治疗时间、并发症、呼吸是否需要呼吸机辅助、气管是否插管或切开、是否有导尿管的留置等。结论   在进行ECMO治疗后很多患者都出现医院感染问题，医院通过分析和总结导致感染的危险因素，并采取合理有效的措施进行预防，能够大大地降低感染率。