Research progress of survival predictive score in veno-arterial extracorporeal membrane oxygenation / 中华危重病急救医学

Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is an extracorporeal circulation technique that provides circulatory and oxygenation support, and it is currently used in the treatment of cardiogenic shock (CS), pulmonary embolism, cardiac arrest (CA), and other diseases. However, this technology is still associated with high complications and mortality. The use of predictive scores for risk stratification before VA-ECMO will be helpful to screen the optimal benefiting population, make optimal clinical decisions, and allocate medical resources reasonably. At present, there are few reports about predictive scores for VA-ECMO. This article systematically reviewed the predictive performance of various scoring tools [the survival after venoarterial ECMO (SAVE) score, prediction of cardiogenic shock outcome for acute myocardial infarction (AMI) patients salvaged by VA-ECMO (ENCOURAGE) score, model for end-stage liver disease (MELD-Ⅺ) score, post-cardiotomy extracorporeal membrane oxygenation (PC-ECMO) score, the predicting mortality in patients undergoing VA-ECMO after coronary artery bypass grafting (REMEMBER) score, predictors of mortality with VA-ECMO for acute massive pulmonary embolism, extracorporeal cardiopulmonary resuscitation (ECPR) score, the hypothermia outcome prediction after extracorporeal life support (HOPE) score] for patients receiving VA-ECMO to provide reference for clinical treatment.

Craniotomy in traumatic frontal sinus fracture cerebrospinal fluid leaks / 中国基层医药

Objective To assess the craniotomy in traumatic frontal sinus fracture cerebrospinal fluid( CSF) leaks.Methods Clinical data of 12 traumatic frontal sinus fracture CSF leaks from January 2010 to December 2014, who treated by craniotomy and conservation treatment was invalid were reviewed.Combined typical clinical presenta-tion and basicranial thin-layer computed tomography(CT),made qualitative diagnosis and localization.Craniotomy by bilateral coronary incision and epidural approach was performed.Repairation was mainly for the endocranium and the basicranium.Bone cement was used to reconstruct the osseous defect of the frontal sinus,and then with pedicle periosteal flap coverage.Dural defects was fixed with autogenous fascia.After operation,staying in bed and using anti-biotic for 7-14 days were required,while mannital or lumbar-drainage as needed.Results All 12 cases got posi-tive preoperative CT results.Craniotomy was performed,succeeded without reoperation.None of intracranial infection happened,while 1 case suffered from anosphrasia.Followed up for 3 -12 months, none CSF leaks relapsed. Conclusion Craniotomy by coronary incision,dispose the endocranium and the basicranium for the patients who suf-fered from frontal sinus fracture CSF leaks while conservation treatment is invalid,can obtain satisfied result.