静脉血栓塞栓症 低体重患者的预防 危急病患者的预防
Helena Knox1, Stephanie B Edwin1, Christopher Giuliano1,2
1Department of Pharmacy, Ascension St. John Hospital, Detroit, MI, USA.
Journal of intensive care medicine
|December 19, 2023
概括
降低剂量静脉血栓塞栓症 (VTE) 预防在重症,低体重患者显著降低出血风险相比标准剂量. 这一策略保持了类似的血栓栓塞事件率,为这个脆弱人群提供了更安全的方法.
科学领域:
- 关键护理医学 关键护理医学
- 药理学 药理学是指药理学的学科.
- 血栓形成和血液静止.
背景情况:
- 静脉血栓塞栓症 (VTE) 预防在重症患者中至关重要.
- 低体重患者在标准VTE预防剂量方面存在独特的挑战.
- 在体重较低的患者中优化静脉瘤预防对于平衡疗效和安全至关重要.
研究的目的:
- 为了比较低剂量和标准剂量VTE预防在重症,低体重患者之间的出血和血栓塞栓事件的发生率.
- 评估在特定患者队列中调整的静脉瘤预防策略的安全性和有效性.
主要方法:
- 多中心,回顾性队列研究,涉及五家升天健康医院.
- 包括体重≤50公斤的成年重症患者,他们接受了降低剂量 (n=140) 或标准剂量 (n=279) 的静脉瘤预防治疗,持续时间≥48小时.
- 分析了复合出血,重大出血,临床相关的非重大出血和静脉动脉突发事件.
主要成果:
- 降低剂量静脉瘤预防与明显较低的复合出血率相关 (5%对12.5%,P=0.02).
- 经过调整后的分析证实,随着降低剂量预防,复合出血减少 (OR:0.36;95% CI:0.14-0.96).
- 静脉瘤发作事件的发生率在两组之间是相似的 (2.2%对0%,P=0.08),在减少剂量组 (3.6%对8.6%,P=0.056) 中,主要出血的趋势较低.
结论:
- 降低剂量静脉瘤预防与重症患者,低体重患者出血风险较低有关.
- 这种调整后的剂量策略似乎是安全和有效的,保持了类似的血栓栓塞事件率.
- 研究结果表明,在这种患者群体中,个性化静脉瘤预防的潜在益处.
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