1. 体外式人工肺装置導入患者における便失禁管理システムの有用性に関する検討(Benefit of fecal incontinence management system during extracorporeal membrane oxygenation)
- Author
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(Shota Kikuta), 菊田 正太, (Satoshi Ishihara), 石原 諭, (Yu Yamane), 山根 悠, (Tokito Koga), 古賀 聡人, (Soichiro Kai), 甲斐 聡一朗, (Akihiko Inoue), 井上 明彦, and (Shinichi Nakayama), 中山 伸一
- Abstract
鼠径部はしばしば便失禁により汚染するが,血管内留置カテーテルへの便汚染を回避する目的で便失禁管理システム(fecal incontinence management system: FMS)を使用した報告は少なく,その有用性を検証した。2010年1月から2015年12月の間に院外心停止(out–of–hospital cardiac arrest: OHCA)に対して体外循環式心肺蘇生(extracorporeal cardiopulmonary resuscitation: ECPR)を行った体外式人工肺装置(extracorporeal membrane oxygenation: ECMO)導入患者のうち,入院後48時間以内の死亡症例,入院後48時間以内のECMO離脱症例を除き,FMSの使用群(31例)と非使用群(32例)について後方視的に検討した。両群間に年齢,性別,体温管理療法や予防的抗菌薬の使用の有無などに差はなく,ECMOカテーテルの留置期間の中央値はいずれも4日であった。入院中の菌血症は非使用群で6例(19%)にみられ,使用群では菌血症は皆無であった(P=0.024)。ECPRでのOHCAに対するECMO導入患者に対し,FMSが菌血症の発症抑制に関与している可能性が示唆された。 Cannulation site is often contaminated by feces because of incontinence. Few reports regarding fecal incontinence management system (FMS) have been discussed for preventing the contamination of intravascular catheters, so we clarify the effect of FMS. We retrospectively studied 63 patients undergoing extracorporeal membrane oxygenation (ECMO) on extracorporeal cardiopulmonary resuscitation (ECPR) for out–of–hospital cardiac arrest (OHCA) between January 2010 and December 2015. Patients were divided into two groups according to the use or no use of FMS. Patients who died within 48 hours or from whom cannulae for ECMO were removed within 48 hours were excluded. Among the 63 patients, 31 underwent FMS. No difference in age, sex, target temperature management, and prophylactic antibiotic use was observed between both the groups. The median duration of ECMO was 4 days in both the groups. The incidence of bacteremia was 0 in the FMS group and 6 (19%) in the no FMS group (P=0.024). FMS may affect the incidence of bacteremia in patients with OHCA undergoing ECMO on ECPR.
- Published
- 2017
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