标准化风险分层血栓预防方案对儿童多系统炎症综合征的临床影响
Roma V Rajput1, Matthew P Sharron1, Padma Pavuluri1
1Children's National Hospital, Washington, DC.
The Journal of pediatrics
|July 20, 2023
概括
对患有多系统炎症综合征 (MIS-C) 的儿童进行标准化血栓预防方案是可行的. 该方案导致了及时的抗凝血治疗和低血栓栓塞 (TE) 和MIS-C患者的出血并发症率.
科学领域:
- 儿科重症监护医药 儿科重症监护医药
- 血液学 血液学 血液学
- 儿童传染病 儿童传染病
背景情况:
- 儿童多系统炎症综合征 (MIS-C) 与血栓栓塞 (TE) 的显著风险有关.
- 需要标准化的协议来管理MIS-C患者的TE风险.
- 血栓预防策略需要在这个脆弱的儿科群体中进行评估.
研究的目的:
- 评估实施机构血栓预防方案对被诊断为MIS-C的儿科患者的临床影响.
- 评估预防性抗凝剂在减少TE事件中的可行性和有效性.
- 为了确定与血栓预防方案相关的出血并发症的发生率.
主要方法:
- 从2020年3月到2021年12月进行了一项单中心回顾性队列研究.
- 这项研究涉及18岁以下的儿童,已确认MIS-C,根据标准化的多学科方法进行管理.
- 高风险患者接受了预防性埃诺沙巴林,并根据目标抗XA因子水平进行调整,如果有必要,在出院后延长时间.
主要成果:
- 在135名MIS-C患者中,92%需要接受ICU治疗,47%有中央静脉导管.
- 在96%的高风险患者中启动了预防性埃诺沙巴林,迅速达到目标水平.
- 观察到较低的症状TE (0.7%) 和临床相关的非重大出血 (4.2%),没有死亡.
结论:
- 对MIS-C实施标准化的机构血栓预防方案是可行的和安全的.
- 该协议有助于及时启动预防性抗凝剂.
- 这种方法与小儿MIS-C患者的低血栓栓塞事件率和出血并发症有关.
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