新型改良低预充体外循环系统的临床应用

A novel modified cardiopulmonary bypass with low prime volume-FUWAI-SAVE system

目的评价新型改良低预充体外循环系统(FUWAI-SAVE系统)的临床效果。方法收集2015年1月1日至2018年1月31日在中国医学科学院阜外医院心脏外科体外循环下成人手术的患者资料,进行1∶1倾向性评分匹配回顾性队列研究,共匹配成功1070名FUWAI-SAVE组患者和1070名常规组患者。主要结局指标为围体外循环期红细胞输注率。结果匹配后两组患者基线数据无差异。FUWAI-SAVE组围体外循环期输血率明显下降(红细胞:34.8%vs.27.2%,P=0.0002;新鲜冰冻血浆:19.1%vs.12.6%,P<0.0001;血小板:0.9%vs.0.1%,P=0.0065)。FUWAI-SAVE组患者ICU医疗费用及住院总费用均明显低于常规组患者。两组患者其他术后结局无明显统计学差异。结论FUWAI-SAVE系统减少临床血制品使用并节约医疗花费。

Objective This study was evaluate the clinical outcomes of FUWAI-SAVE system and to share its application ex⁃perience.Methods This was a propensity-matched observational cohort study.Patients who underwent cardiac surgery in Fuwai Hos⁃pital discharged from 1/1/2015 to 31/1/2018 were evaluated.After 1:1 propensity-matching,a cohort with 1070 patients underwent conventional cardiopulmonary bypass(CPB)and 1070 patients underwent the FUWAI-SAVE system was created.The primary out⁃come was red blood cell transfusion rate.Results There was no significant difference between the two groups in demographic charac⁃teristics.Red cell blood transfusion was significantly decreased in the FUWAI-SAVE group(34.8%vs 27.2%,P=0.0002),and the same with fresh frozen plasma and platelet transfusion(19.1%vs 12.6%,P<0.0001;0.9%vs 0.1%,P<0.0001).Compared to the conventional CPB group,FUWAI-SAVE group exhibited less intensive care unit costs and in-hospital costs.No significant difference was observed regarding mortality between the two groups.Conclusion The FUWAI-SAVE system can reduce perioperative transfusion and save health care costs.