根据常规凝血测试发现高凝血状态,使用旋转血栓等度测试在患有败血症的患者中发现高凝血状态:一项观察性研究
H-D Bui-Thi1, D-K Nguyen, G-K To
1Department of Intensive Care, University Medical Center Ho Chi Minh City, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam. khoi.lm@umc.edu.vn.
概括
旋转性血栓形成显微镜 (ROTEM) 与传统测试不同,可以准确地识别败血症患者的高凝血. 纤维素水平升高是这种败血症引起的高凝血能力的关键驱动因素.
科学领域:
- 关键护理医学 关键护理医学
- 血液学 血液学 血液学
- 败血症病理生理学病理生理学
背景情况:
- 传统的凝血测试 (CCT) 通常无法检测血症患者的高凝血.
- CCT可能导致低凝血的过度诊断,导致不必要的输血.
研究的目的:
- 使用旋转血栓形成显微镜 (ROTEM) 来分类异常CCT的败血症患者的凝血状况.
- 确定影响血症凝血状态的关键凝血成分.
主要方法:
- 161名败血症患者的观察研究 (败血症-3标准).
- 在ICU入院24小时内同时进行CCT和ROTEM评估.
- 从患有异常CCT (aPTT比率,INR,血小板计数,纤维素原) 的患者提取的数据.
主要成果:
- ROTEM在最初被诊断为CCT的低凝血症的败血症患者中发现了高凝血.
- 过高凝固性与最大凝块坚度的增加和显著更高的血纤维素度有关.
- 具体发现包括INR≥1.6的患者中11.8%的高凝血,低血小板计数患者中3.5%.
结论:
- ROTEM有效地检测了CCT在败血症中错过的高凝血能力.
- 超纤维蛋白质血症是败血症患者高凝血的一个重要因素.
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