低分子量肝素在血管压缩剂患者的皮下生物可用性
Lancet (London, England)
|March 19, 2002
概括
接受血管压缩剂的重症监护室 (ICU) 患者显示低分子量肝素 (LMWH) 预防静脉血栓栓塞的有效性降低. 这表明需要在这些危急患者中调整LMWH剂量或给药量.
科学领域:
- 关键护理医学 关键护理医学
- 药理学 药理学是指药理学的学科.
- 血管医学 血管医学
背景情况:
- 静脉血栓栓塞 (VTE) 是重症监护室 (ICU) 患者的常见并发症.
- 经常使用皮下低分子量肝素 (LMWH) 的预防性治疗,但在某些ICU人群中可能具有低于最佳的疗效.
研究的目的:
- 调查血管压缩剂给药对LMWH预防VTE的疗效的影响.
- 为了比较接受血管压缩剂的ICU患者与未接受血管压缩剂的ICU患者的XA活性水平,以及与普通手术患者的XA活性水平.
主要方法:
- 这是一项比较性研究,涉及三组每组15名患者.
- 测量血XA因子活性度.
- 包括使用血管压缩剂的ICU患者,不使用血管压缩剂的ICU患者和一般手术患者.
主要成果:
- 接受血管压缩剂的ICU患者表现出显著较低的XA因子血活性度.
- 这种减少在与不使用血管压缩剂的ICU患者和术后对照组相比,都被观察到.
- 由于血管压缩剂导致的周围循环受损可能导致LMWH的系统生物可用性不足.
结论:
- 在ICU患者中使用血管压缩剂可能会损害标准皮下LMWH预防的有效性.
- 较高的剂量或LMWH的替代施用方法可能是必要的,以充分预防ICU患者的血管压缩器的血栓形成.
- 进一步的研究是有必要的,以优化VTE预防策略在这个脆弱的患者群体.
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