在产后出血中,限制性与自由的液体施用策略 (REFILL研究) 以及其对血栓凝结仪 (ROTEM®) 值的影响:一种随机对照试验
Pim B B Schol1,2, Natascha de Lange3, Yvonne Henskens4
1Department of Obstetrics and Gynecology, Maastricht University Medical Centre, Maastricht, The Netherlands.
The Journal of international medical research
|August 3, 2023
概括
产后出血 (PPH) 流体管理策略对凝血没有显著影响. 在早期的PPH中,限制性或自由的液体给药并没有改变血栓显着度或凝血参数.
科学领域:
- 产科和妇科 产科和妇科
- 麻醉学 麻醉学
- 关键护理医学 关键护理医学
背景情况:
- 目前对于产后出血 (PPH) 的产科指南为液体复苏提供了多种建议.
- 了解液体管理对凝血的影响对于优化PPH治疗至关重要.
研究的目的:
- 评估限制性与自由性液体管理策略在产后出血早期对凝血参数的影响.
主要方法:
- 一个多中心的随机试验,涉及249名患有PPH (≥500毫升血液损失) 的女性.
- 患者被随机分配到限制性或自由的液体管理.
- 进行了旋转性血栓形成显微镜 (ROTEM) 和标准凝血测试.
主要成果:
- 在基线校正后,在流体管理组之间没有观察到血静参数 (EXTEM CT,A10,INTEM CT,FIBTEM A10) 的显著差异.
- 平均纤维素度,激活的部分血栓形成时间和部分血栓形成时间也没有显著的群体间差异.
结论:
- 在PPH<1500毫升的女性中,无论是限制性的还是自由的液体输送策略,都没有显示出对血栓显着度或标准凝血参数的临床相关影响.
- 这些发现表明,目前的流体管理方法可能不会显著影响早期PPH凝血动态.
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