危急病患者持续置换治疗的抗凝血选择:随机对照试验的系统性审查和网络元分析
Zhifeng Zhou1, Chen Liu1, Yingying Yang1
1Department of Nephrology, Kidney Research Institute, West China Hospital of Sichuan University, Chengdu, 610041, China.
Critical care (London, England)
|June 7, 2023
概括
区域酸盐抗凝药 (RCA) 优先于未分离氨酸 (UFH) 用于连续脏替代疗法 (CRRT),因为过器寿命更长,出血减少. 对于其他抗凝血剂,还需要更多的研究.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 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.
背景情况:
- 持续置换疗法 (CRRT) 对于患有急性损伤 (AKI) 的重症患者至关重要.
- 身体外电路凝血经常会中断CRRT,需要有效的抗凝策略.
- 目前的抗凝药选择缺乏关于有效性和安全性的全面比较研究.
结论:
- 在重症患者中,RCA是CRRT的首选抗凝剂,而不是UFH.
- 对于Regional-UFH加PGI2的证据有限,因此在推之前需要进行高质量的试验.
- 进一步的大规模RCT对于优化CRRT抗凝策略至关重要,旨在降低死亡率和不良事件,同时改善功能恢复.
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