肌素清除率预测了创伤性脑损伤中的目标埃诺沙巴林剂量
Greigory Park1, Navpreet K Dhillon, Nicole M Fierro
1From the Division of Trauma and Critical Care, Department of Surgery (G.P., N.M.F., P.D., J.S., E.J.L.), Cedars-Sinai Medical Center, Los Angeles, California; and R Adams Cowley Shock Trauma Center (N.K.D.), University of Maryland, Baltimore Maryland.
The journal of trauma and acute care surgery
|June 19, 2023
概括
肌素清除比基于体重的方法更好地预测创伤性脑损伤 (TBI) 患者的埃诺沙巴林剂量. 这一发现表明,在TBI中采取更个性化的方法来预防VTE.
科学领域:
- 创伤外科 手术 创伤外科
- 药理学 药理学是指药理学的学科.
- 神经外科 神经外科
背景情况:
- 患有创伤性脑损伤 (TBI) 的患者面临静脉血栓塞栓症 (VTE) 的高风险.
- 目前的指导方针建议TBI患者初始使用埃诺沙巴林剂量,并考虑基于体重的调整.
- 功能,特别是肌素清除率 (CrCl),可能比体重更为准确地为素剂量调整提供了更准确的基础.
研究的目的:
- 调查肌素清除率 (CrCl) 是否更好地预测TBI患者的目标素剂量,而不是基于体重的剂量.
- 评估CrCl和埃诺沙巴林在TBI患者的剂量要求之间的相关性.
- 为了比较CrCl与体重的预测值,以对沙的剂量进行比较.
主要方法:
- 对120名患有TBI (头部和部AIS≥3) 的成人患者的回顾性评估,这些患者被录取到一级创伤中心.
- 纳入标准:年龄大于18岁,入院时间大于48小时,服用埃诺沙巴林12小时,并抽出抗Xa水平.
- 皮尔森的相关性被用来比较平均CrCl和平均体重在埃诺沙巴林剂量队列.
主要成果:
- 平均CrCl与增加埃诺沙巴林剂量要求显著正相关 (r=0.484,p<0.001).
- 平均体重也与增加的埃诺沙巴林剂量需求相关 (r=0.411,p<0.001),但不如CrCl.Cl.强度.
- 研究人口 (n=120) 的平均年龄为47岁,68%是男性,平均住院时间为24天.
结论:
- 与基于体重的策略相比,肌素清除在TBI患者的目标素剂量预测准确度更高.
- 这些发现支持使用CrCl优化VTE预防TBI.
- 需要对更大的队列进行进一步的研究,以验证在TBI中CrCl引导的埃诺沙巴林剂量协议.
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