关于ECMO-A叙述审查患者抗凝血策略的最新情况
Ján Šoltés1,2, Michal Skribuckij3, Hynek Říha1,4
1Department of Anaesthesiology and Intensive Care Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, 12808 Prague, Czech Republic.
Journal of clinical medicine
|September 28, 2023
概括
身体外膜氧化 (ECMO) 显著影响血液凝固. 目前的管理通常使用未分离的肝素,但由于凝血的复杂变化,个性化的方法至关重要.
科学领域:
- 关键护理医学 关键护理医学
- 通过心肺绕道术 (cardiopulmonary bypass) 进行心肺绕道.
- 血液学 血液学 血液学
背景情况:
- 身体外膜氧化 (ECMO) 的使用正在迅速增加,用于严重的呼吸和循环功能衰竭.
- 患者的危急疾病和ECMO电路显著破坏正常的血液静止.
- 了解抗凝剂对于ECMO患者的安全性和有效性至关重要.
研究的目的:
- 审查关于ECMO患者抗凝管理的当前知识.
- 讨论既定和替代的抗凝策略.
- 要突出不断发展的凝血状态监测技术.
主要方法:
- 在ECMO治疗中对抗凝血的文献综述.
- 讨论未分离的肝素作为黄金标准.
- 探索替代抗凝剂和先进的监测方法.
主要成果:
- 与激活的部分血栓塑时间监测一起的未分离的肝素是当前的标准.
- 讨论了替代性抗凝剂和血栓凝结学监测.
- 在管理ECMO相关的静血性变化方面存在显著的证据缺口.
结论:
- ECMO患者表现出复杂的,多因素的凝血系统乱.
- 目前的抗凝血策略需要仔细,个性化的患者管理.
- 需要进一步的研究来优化ECMO治疗中的抗凝血方案.
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