在儿童患者中使用Argatroban,这些患者由体外心室辅助器件支持
Merritt G Tuttle1, Ke Yan2, Jian Zhang2
1From the Department of Pediatric Critical Care Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin.
概括
与未分离肝素 (UFH) 相比,阿尔加特罗班在带有心室辅助器件 (VAD) 的儿童中没有显示出改善的结果. 这项研究发现,抗凝血策略之间的中风,出血或死亡率没有显著差异.
科学领域:
- 儿童心脏病学 儿童心脏病学
- 血液学 血液学 血液学
- 临界护理医学 临界护理医学
背景情况:
- 直接血栓抑制剂 (DTI) 与儿科心室辅助器件 (VAD) 患者的更好的结果有关.
- 有限的数据存在于这个人群中的阿格拉斯罗班使用,大多数研究集中在比瓦利鲁丁.
研究的目的:
- 在儿科VAD患者中,比较阿格拉斯罗班与未分离肝素 (UFH) 的疗效和安全性.
- 为了调查 argatroban 和 UFH 抗凝策略之间的出血,中风和死亡率.
主要方法:
- 对儿科患者 (<18岁) 进行了回顾性队列研究,这些患者使用的是体VAD.
- 患者被划分为 argatroban 和 UFH 抗凝剂组.
- 统计分析包括千平方,费舍尔的精确和曼-惠特尼U测试.
主要成果:
- 在 argatroban 和 UFH 组之间没有观察到中风,出血或死亡率的显著差异.
- 十九名儿童接受了阿布拉特罗班,16名儿童接受了UFH;人口统计学是相似的.
- 高率的先前体外膜氧化 (ECMO) 使用复杂的发现.
结论:
- 在儿童VAD接受者中,Argatroban没有被发现是优于UFH的抗凝剂.
- 需要进一步的研究来澄清这个复杂的患者群体中最佳的抗凝剂.
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