在小儿心脏病患者中激活的前原复合度,我们的早期经验
Elena Ashikhmina Swan1, Nathan J Brinkman2, Brian D Lahr3
1Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA.
概括
激活型前激素复合物缩剂 (FEIBA) 并没有减少小儿心脏手术患者的输血需求. 这项研究发现,在使用FEIBA时,心肺旁路术后输血血液产品的输血没有显著差异.
科学领域:
- 儿科心脏手术 儿科心脏手术
- 血静管理 血静管理
- 输血医学 输血医学
背景情况:
- 儿童心脏手术往往导致异常凝血和大量出血,需要频繁的输血.
- 患者血液管理策略旨在减少输血,正在探索前血组复合物缩剂 (PCC).
- 关于PCC在儿科心脏外科手术中的有效性存在有限的数据,与成人不同.
研究的目的:
- 评估激活PCC第八因子抑制剂绕过活动 (FEIBA) 在小儿心脏手术后减少输血需求的安全性和有效性.
- 评估非标签FEIBA使用对接受心肺旁路术 (CPB) 的儿童血液静止的影响.
主要方法:
- 对儿童 (≤15公斤) 进行心脏手术的观察研究.
- 倾向性评分分析以匹配接受FEIBA和未接受FEIBA的患者.
- 对输血量和凝血参数的医疗记录的审查.
主要成果:
- 在FEIBA和对照组 (28对22毫升/公斤) 之间,CPB后输血体积没有显著差异.
- FEIBA组在ICU到达时显示出较低的初始国际规范化比率 (INR) 和较高的血红蛋白,但这些差异没有持续.
- 在210名符合条件的患者中,有44名接受FEIBA治疗;分析了40名匹配对.
结论:
- 在这项探索性研究中,FEIBA的使用没有改变小儿心脏手术和CPB后的输血要求.
- 需要进一步的研究来澄清FEIBA在儿科血静管理中的作用.
相关概念视频
01:29Venous Thrombosis III: Interprofessional Care
11
Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
11
01:28Cardiac Catheterization I: Pre-Procedure Overview
77
Cardiac catheterization is an invasive diagnostic technique used to identify and evaluate structural and functional diseases of the heart and major blood vessels. This technique diagnoses congenital heart disease, coronary artery disease, valvular heart disease, and coronary spasms and assesses ventricular function. It helps guide treatment decisions, including the need for revascularization procedures like percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) and...
77
01:30Anticoagulant Drugs: Low-Molecular-Weight Heparins
767
Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
767
01:20Extrinsic and Intrinsic Pathways of Hemostasis
8.4K
Blood clotting or coagulation involves extrinsic and intrinsic pathways, which ultimately merge into the common pathway, forming a fibrin clot.
The Extrinsic Pathway
The extrinsic pathway of coagulation is typically initiated by tissue damage that exposes blood to tissue factor (TF), a protein released by the damaged tissue cells outside the blood vessels—this interaction with TF triggers biochemical reactions involving specific clotting factors. The key player here is Factor VII, which...
The Extrinsic Pathway
The extrinsic pathway of coagulation is typically initiated by tissue damage that exposes blood to tissue factor (TF), a protein released by the damaged tissue cells outside the blood vessels—this interaction with TF triggers biochemical reactions involving specific clotting factors. The key player here is Factor VII, which...
8.4K
01:09Coagulation
7.2K
The coagulation phase is a critical part of the body's process to prevent blood loss following injury to blood vessels. It involves chemical reactions that form a clot to seal the injured area. The clotting process begins shortly after injury, within 15-20 seconds for severe damage and 1-2 minutes for minor injuries.
During the coagulation phase, clotting factors, or procoagulants, play a vital role in initiating and progressing the coagulation cascade. This cascade is a series of reactions...
During the coagulation phase, clotting factors, or procoagulants, play a vital role in initiating and progressing the coagulation cascade. This cascade is a series of reactions...
7.2K
01:26EDTA: Auxiliary Complexing Reagents
631
EDTA titrations are usually carried out in highly basic conditions, where the fully deprotonated form of EDTA, Y4−, actively complexes with the free metal ions in the solution. Several metal ions precipitate as hydrous oxide (hydroxides, oxides, or oxyhydroxides) under these conditions, lowering the concentration of free metal ions in the solution. For this reason, auxiliary complexing agents or ligands such as ammonia, tartrate, citrate, or triethanolamine are used in EDTA titrations to...
631