Relationship Between Timing Of Microcirculation Improvement And Prognosis Of Patients Undergoing Extracorporeal Membrane Oxygenation

Background:Studies have shown that the microcirculation status of patients with extracorporeal membrane oxygenation is closely related to the prognosis of patients.However,there are still no biochemical index value,imaging characteristics and ultrasonic manifestations that can accurately indicate the improvement of microcirculation in patients,especially the determination of the timing of microcirculation improvement in patients with extracorporeal membrane oxygenation is still a major clinical problem that has not been solved.Aims:This study mainly discusses the relationship between the timing of microcirculation improvement and the prognosis of patients undergoing extracorporeal membrane oxygenation,so as to help clinicians predict the prognosis of patients undergoing extracorporeal membrane oxygenation in clinical work.Methods:The clinical data of 35 patients who needed ECMO treatment in the emergency ICU of THE SECOND AFFILIATED HOSPITAL TO NANCNAG UNIVERSITY from December 2018 to December 2021 were retrospectively analyzed,which met the treatment standards and operating procedures of ECMO center guidelines issued by the Extracorporeal Life Support Organization(ELSO)in2014 for various reasons.The correlation between the timing of microcirculation improvement and gender,age,ICU hospitalization days,total hospitalization days,ECMO on-line days,ECMO mode and prognosis of patients were analyzed.Results:The timing of microcirculation improvement was significantly positively correlated with the prognosis of patients treated with extracorporeal membrane oxygenation.When microcirculation was improved,the creatinine(Cre)of patients was usually less than 104.8 umol/L,and the 24-hour total urine volume of patients was usually greater than 3616 m L.The timing of microcirculation improvement in the survival group was significantly earlier than that in the death group.When the difference between the time point when creatinine(Cre)was less than 104.8 umol/L and the time point when the microcirculation was improved,the difference was positively correlated with the prognosis of patients(r_s=0.601**,P=0.0002).There was no correlation with gender(r_s=-0.22,P=0.218),age(r_s=0.053,P=0.771),ICU hospitalization days(r_s=0.271,P=0.128),total hospitalization days(r_s=0.086,P=0.636),ECMO on-line days(r_s=0.323,P=0.067),ECMO mode(r_s=0.217,P=0.225).When the difference between the time point of 24-hour total urine volume greater than 3616 m L and the time point of starting the machine was used to judge the timing of microcirculation improvement,the difference was positively correlated with the prognosis of patients(r_s=0.553**,P=0.001).There was no correlation with gender(r_s=0.211,P=0.237),age(r_s=0.136,P=0.451),ICU hospitalization days(r_s=0.211,P=0.24),total hospitalization days(r_s=-0.002,P=0.991),ECMO on-line days(r_s=0.251,P=0.159),ECMO mode(r_s=0.232,P=0.194).Conclusions:The timing of microcirculation improvement is closely related to the prognosis of patients undergoing extracorporeal membrane oxygenation.Therefore,in clinical work,clinicians can predict the prognosis of patients through the timing of microcirculation improvement,so as to develop individualized diagnosis and treatment programs for patients.