在儿科外体膜氧化期间用于全身抗凝药的比瓦利鲁丁或氨酸:多中心回顾性研究
Mohammed Hamzah1, Troy G Seelhammer2, Asaad G Beshish3
1Department of Pediatric Critical Care, Cleveland Clinic Children's, Cleveland, OH, USA.
Thrombosis research
|July 30, 2023
概括
在儿科外体膜氧化 (ECMO) 中使用比瓦利鲁丁抗凝剂显示出较低的出血和血栓事件. 这种抗凝剂还改善了与未分离氨酸 (UFH) 相比的生存率和神经结果.
科学领域:
- 儿科重症监护医药 儿科重症监护医药
- 心血管研究的心血管研究.
- 药理学和治疗学 药理学和治疗学
背景情况:
- 儿科外体膜氧化 (ECMO) 需要有效的抗凝剂.
- 不分离的肝素 (UFH) 是一种常见的抗凝剂,但可能与并发症有关.
- 像比瓦利鲁丁这样的替代抗凝剂正在为儿科ECMO探索.
研究的目的:
- 为了比较比瓦利鲁丁与UFH在ECMO治疗儿科患者中的疗效和安全性.
- 评估结果,包括出血,血栓形成,输血产品,医院生存和神经功能.
主要方法:
- 在2017年6月至2020年5月期间,ECMO对儿科患者 (18岁以下) 的多中心回顾性研究.
- 根据年龄和ECMO类型,UFH患者与比瓦利鲁丁患者的比率为2:1匹配.
- 分析了结果,比较了两个抗凝固剂组.
主要成果:
- 比瓦利鲁丁的使用与出血事件 (aOR 0.23) 和血栓事件 (aOR 0.48) 的几率明显降低.
- 服用比瓦利鲁丁的患者需要更少的新鲜冷血和血小板输血.
- 比瓦利鲁丁与医院死亡率下降50% (aOR0.50) 和完整神经结果的更高几率 (OR1.99) 相关.
结论:
- 比瓦利鲁丁在儿科ECMO中提供有效的抗凝剂,减少出血和血液制品的使用.
- 与UFH相比,比瓦利鲁丁与改善的医院生存率和神经功能有关.
- 建议通过潜在的随机试验进行进一步验证.
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