ECMO专用抢救车在急诊成人体外心肺复苏患者临床救治中的应用效果

Application effect of ECMO special rescue cart in clinical treatment of adult patients with extracorporeal cardiopulmonary resuscitation in emergency department

目的观察体外膜肺氧合(ECMO)专用抢救车在急诊成人体外心肺复苏(ECPR)患者临床救治中的应用效果。方法采用便利抽样法,选取2020年1月—2022年8月南京医科大学第一附属医院急诊抢救室救治的成人体外心肺复苏患者43例。将2020年1月1日—2021年4月30日救治的20例急诊ECPR患者归为对照组,采用急诊常规救治模式;将2021年5月1日—2022年8月31日救治的23例急诊ECPR患者归为观察组,运用ECMO专用抢救车参与救治。两组患者性别、年龄、入室诊断、ECMO模式、急诊ECMO专家置管经验比较差异无统计学意义(P>0.05)。比较两组急诊ECMO团队到达用时、护士备物用时、ECMO上机用时、医生对护士工作的满意度、追踪患者结局。结果观察组急诊ECMO团队到达用时、护士备物用时、ECMO上机用时均低于对照组,医生对护士工作的满意度高于对照组,组间差异均有统计学意义(P<0.05)。观察组患者的存活率高于对照组,但差异不具有统计学意义(P>0.05)。结论ECMO专用抢救车应用于急诊成人ECPR患者的救治中,可有效减少急诊ECMO团队到达用时,护士备物用时,以加快ECMO上机速度,提高患者抢救效率,可在一定程度上改善患者结局;也提高了医生对护士工作的满意度,值得在急诊临床一线推广使用。

Objective To observe the application effect of extracorporeal model oxygenation(ECMO)special rescue cart in clinical treatment of adult patients with extracorporeal cardiopulmonary resuscitation(ECPR)in emergency department.Methods Using the convenient sampling method,43 adult patients with extracorporeal Cardiopulmonary resuscitation treated in the emergency room of the First Affiliated Hospital of Nanjing Medical University from January 2020 to August 2022 were selected.A total of 20 emergency ECPR patients treated with emergency routine mode from January 1,2020 to April 30,2021 were classified as the control group.A total of 23 emergency ECPR patients treated from May 1,2021 to August 31,2022 were divided into the observation group,and the ECMO special rescue cart was used in the treatment.There was no statistically significant difference in gender,age,entry diagnosis,ECMO mode and emergency ECMO expert catheterization experience between the two groups(P>0.05).The arrival time of emergency ECMO team,the time of nurses'preparation,the time of ECMO on the machine,the satisfaction of doctors with nurses'work,and the outcome of tracking patients were compared between the two groups.Results The time of arrival of emergency ECMO team,the time of nurses'preparation and the time of ECMO on the machine in the observation group were lower than those in the control group,and the satisfaction of doctors to nurses'work was higher than that in the control group,and the differences between the groups were statistically significant(P<0.05).The survival rate of the observation group was higher than that of the control group,but the difference was not statistically significant(P>0.05).Conclusion The application of ECMO special rescue cart in the treatment of adult patients with ECPR can effectively reduce the time of arrival of emergency ECMO team,the time of nurses'preparation,accelerate the speed of operation of ECMO machine,improve the rescue efficiency of patient,and improve the outcome of patients to a certain extent.It also improves doctors'satisfaction with nurses'work,so it is worth promoting and using in the emergency clinical frontline.