在非心脏动脉手术中未分离的肝素和激活的凝血时间
Liliane C Roosendaal1,2,3, Willemijn van den Ancker4, Arno M Wiersema1,2,3
1Department of Vascular Surgery, Dijklander Ziekenhuis, Hoorn, the Netherlands.
The Journal of cardiovascular surgery
|May 31, 2023
概括
在非心脏动脉手术过程中,未分离的肝素的效果是不可预测的. 激活凝血时间 (ACT) 可以监测肝素.
科学领域:
- 心血管医学 心血管医学
- 血液学 血液学 血液学
- 麻醉学 麻醉学
背景情况:
- 未分离的肝素对于预防非心脏动脉手术 (NCAP) 中的血栓栓塞并发症至关重要.
- 监测肝素的抗凝剂作用对于患者的安全至关重要.
- 激活凝血时间 (ACT) 是这种监测的一个关键测试.
研究的目的:
- 在NCAP期间审查关于肝素监测的文献.
- 为了提供激活凝血时间 (ACT) 测试的概述.
- 为了确定影响ACT测量的因素.
主要方法:
- 在PubMed.com上进行了全面的文献搜索.
- 精选的文章集中在肝素,各种凝血时间测试和ACT设备上.
- 该审查综合了关于ACT测量和影响因素的信息.
主要成果:
- 肝素对个体患者的影响是不可预测的;ACT可以测量这种影响.
- 诸如血液稀释,低温和血小板缺血等因素会影响ACT.
- 不同的测量设备之间存在 ACT 结果的显著差异.
- 对NCAP的最佳ACT目标缺乏共识;ACT>250s与增加的出血有关.
- 雌性在肝素注射后表现出更长的ACT和更高的出血风险.
结论:
- 肝素的抗凝剂作用是可变的,最好通过个性化的ACT监测.
- 在NCAP期间,ACT监测允许量身定制的抗凝剂.
- 由于ACT对影响因素和设备可变性的敏感性,建议谨慎使用.
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