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在心脏和胸前大动脉手术中估计和观察到的肝素敏感度指数之间的关系

Hitomi Nakatani^1,2, Mitsuru Ida³, Taichi Kotani²

¹Department Resource Nurse Center, Nara Medical University, 840 Shijo-Cho, Kashihara, Nara, 634-8522, Japan.

JA clinical reports

|August 4, 2023

概括

该研究发现,在成人心脏手术患者中,估计和观察到的肝素敏感性指数 (HSI) 之间的相关性很低. 需要更准确的公式来使用临床数据可靠地估计HSI.

科学领域:

心脏病学心脏病学
麻醉学麻醉学
血液学血液学血液学

背景情况:

关于成年人估计和观察到的肝素敏感性指数 (HSI) 之间的相关性数据有限.
这项研究旨在评估心脏和胸前动脉手术的成年患者估计和观察到的HSI之间的关系.

研究的目的:

评估估计的肝素敏感性指数 (HSI) 与观察到的HSI之间的相关性.
确定与成人手术患者的HSI相关的临床和实验室因素.

主要方法:

对560名接受心脏和胸前大动脉手术的成年患者进行了回顾性研究,这些患者需要心肺旁路.
使用激活凝血时间 (ACT) 和初始氨酸剂量计算观察到的HSI.
使用临床因素的多重回归分析开发了估计的HSI,包括年龄,性别,血小板计数和纤维素原-白蛋白比率指数.

主要成果:

多重回归确定了血液透析,血小板计数,纤维激素-白蛋白比率指数,基线ACT和初始肝素剂量作为与HSI相关的显著因素.
平均观察到的HSI为1.38 (SD 0.43),平均估计的HSI为1.55 (SD 0.13).
观察到和估计的HSI之间的类内相关系数低于0.10.

结论:

观察和估计的肝素敏感性指数 (HSI) 之间的相关性在这个成年手术队列中很低.
目前基于临床数据估计HSI的方法缺乏高精度.
需要进一步的研究来开发一个更精确的公式来估计HSI.

关键词:

激活的凝血时间通过心肺绕道术 (cardiopulmonary bypass) 进行心肺绕道.肝素耐药性肝素耐药性肝素敏感性指数是指肝素敏感性指数.

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