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在V-V ECMO患者的抗凝血管理:一个多学科的实用性协议

Ana Bento Rodrigues^1,2,3, Anabela Rodrigues⁴, Catarina Jacinto Correia⁴

¹Serviço de Medicina Intensiva, Centro Hospitalar Universitário Lisboa Norte, 1649-028 Lisboa, Portugal.

Journal of clinical medicine

|February 10, 2024

概括

在体外膜氧化 (ECMO) 中个性化抗凝药非常重要. 建议采用多测试监测方法,以量身定制的患者管理,以平衡血栓形成和出血风险.

科学领域:

心血管研究研究心血管研究
血液学血液学血液学
关键护理医学关键护理医学

背景情况:

身体外膜氧化 (ECMO) 在控制血栓形成和出血风险方面存在复杂的挑战.
目前ECMO的抗凝固管理缺乏高质量的数据,导致实践的显著变化.
本次审查涉及凝血监测,并提出了一个管理策略,从一个大量的ECMO中心.

研究的目的:

审查ECMO目前的抗凝药选择和监测方法.
为ECMO患者的凝血管理提出一个务实的,多方面的方法.
突出了个性化抗凝策略的需要.

主要方法:

通过使用关键词进行了PubMed文献搜索:"抗凝"",凝血测试"",ECMO"",ELSO"和"ISTH".
审查了与ECMO相关的可用的抗凝剂和监测技术.
描述了在大量的ECMO推中心的抗凝血和监测的常规实践.

主要成果:

没有单一的凝血试验可以可靠地预测ECMO患者的出血或血栓风险.
目前的文献和实践显示,抗凝血管理协议的差异很大.
为了有效监测,需要进行全面的实验室评估.

结论:

对ECMO患者来说,一个量身定制的,个性化的抗凝疗方案是强制性的.
建议的监测包括测试的组合:抗Xa,激活的部分血栓形成时间 (aPTT),激活的凝血时间 (ACT),粘弹性测试,抗血 (AT) 水平,血小板计数,纤维素素和XIII因子 (FXIII) 水平.
个性化抗凝管理需要整合多个实验室分析的结果.

关键词:

在ECMO中,可以使用ECMO.这是一种抗凝血药物.流血出血流血出血协议协议协议协议协议测试测试测试测试测试血栓形成的原因是血栓形成.

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