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在ECMO中使用全身抗凝剂
Shannon M Larabee1, Laura E Hollinger2, Adam M Vogel1
1Texas Children's Hospital and Baylor College of Medicine, United States.
Seminars in pediatric surgery
|November 15, 2023
概括
未分离的氨酸 (UFH) 和直接的血栓抑制剂 (DTI) 是儿科外体生命支持 (ECMO) 的关键抗凝剂. 本综述详细介绍了它们的使用,监测和指导方针,并指出儿童ECMO抗凝药缺乏共识.
科学领域:
- 儿科重症监护医药 儿科重症监护医药
- 血液学 血液学 血液学
- 进行心血管外科手术.
背景情况:
- 未分离的肝素 (UFH) 是儿科外体生命支持 (ECMO) 的标准抗凝剂.
- 直接血栓抑制剂 (DTI) 越来越多地被用作替代品或辅助剂.
- 在儿科ECMO中最佳的抗凝管理仍然具有挑战性,因为证据有限,实践不断变化.
研究的目的:
- 审查目前关于UFH和DTI在儿科ECMO中使用的证据.
- 为了比较UFH和DTI的优缺点.
- 概述抗凝血监测策略和儿科ECMO的最新指导方针.
主要方法:
- 关于UFH和DTI在儿科ECMO中使用的最新证据的文献综述.
- 抗凝剂特性,疗效和安全性资料的比较.
- 分析体外生命支持组织 (ELSO) 准则和常见的临床实践.
主要成果:
- 在儿科ECMO中,UFH和DTI提供了不同的好处和风险.
- 有效的抗凝血监测对于患者的安全至关重要.
- 目前的指导方针提供了一个框架,但对于儿科ECMO抗凝药缺乏共识.
结论:
- 对UFH和DTI使用的基于证据的审查支持儿科ECMO的知情临床决策.
- 量身定制的抗凝策略,考虑到患者特异性因素和程序风险,是必不可少的.
- 需要进一步的研究,以建立关于儿科ECMO抗凝药的最终共识建议.
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