在血交换中使用酸盐抗凝剂,然后在危急儿童中进行连续的脏替代疗法
Zhang Xinping1, He Jie1, Yao Zhenya1
1Department of Critical Care Medicine, Hunan Children's Hospital, Changsha, Hunan, China.
The International journal of artificial organs
|January 16, 2024
概括
区域酸盐抗凝血血交换 (RCA-PE) 在重症儿童中显示出优异的过性能. 连续连续的脏替代疗法 (CRRT) 在RCA-PE后有效改善了酸盐相关的代谢性.
科学领域:
- 儿科重症监护医学 儿科重症监护医学
- 脏替代疗法治疗 脏替代疗法
- 身体以外的治疗方法
背景情况:
- 血交换 (PE) 对重症儿童至关重要,但需要有效的抗凝药.
- 区域酸盐抗凝药 (RCA) 是PE期间全身肝素抗凝药 (SHA) 的替代品.
- 酸盐的积累可能导致代谢障碍,需要仔细监测和管理.
研究的目的:
- 评估RCA-PE在重症儿童的疗效和安全性.
- 确定连续脏替代疗法 (CRRT) 是否可以缓解RCA-PE后的酸盐相关代谢障碍.
- 在过性能和代谢结果方面,将RCA-PE与SHA-PE进行比较.
主要方法:
- 一个回顾性,单中心的观察性研究,对79名重症儿童进行了PE,随后进行了CRRT.
- 患者被分为RCA-PE (n=30) 和SHA-PE (n=49) 组.
- 在PE和CRRT之前和之后评估过器性能和代谢参数 (pH,HCO3−).
主要成果:
- 与SHA-PE相比,RCA-PE显示出更优越的过器性能.
- 最初,RCA-PE与更高的代谢性病发病率 (48.3%) 相关.
- 顺序CRRT显著降低了RCA-PE组的代谢性 (13.8%),与SHA-PE相比将结果正常化.
结论:
- 区域酸盐抗凝剂在重症儿童的血交换过程中提供了更好的过性能.
- 持续的置换疗法有效地管理与RCA-PE相关的代谢性.
- 在CRRT之后的RCA-PE是儿科PE抗凝药的可行和改进的替代方案.
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