在外科患者群体中使用非标签型前素复合缩物 (四因素前素复合缩物) 的利用和安全性
Katherine Sandquist1, Kevin Kaucher, Joshua Newell
1Department of Pharmacy, University of New Mexico Hospital, Albuquerque, New Mexico, USA.
概括
四因素原胺复合缩剂 (4F-PCC) 在非抗凝血手术患者中显示出静血疗效. 然而,它的非标签性使用带来了风险,包括血栓栓塞事件和频繁的血液制品管理.
科学领域:
- 麻醉学 麻醉学
- 血液学 血液学 血液学
- 手术护理 手术护理
背景情况:
- 四因子原复合缩剂 (4F-PCC) 用于治疗出血,但其在非抗凝血手术患者中的安全性和有效性尚未明确.
- 在这个人群中,非标签使用4F-PCC缺乏强有力的指导.
研究的目的:
- 评估4F-PCC在非抗凝血手术患者中的利用和安全性.
- 评估静血疗效和识别相关风险.
主要方法:
- 对接受4F-PCC治疗的非抗凝血成年患者 (≥18岁) 进行了回顾性,单中心的图表审查,用于手术/术后指示.
- 2017年1月至2022年9月期间收集的数据.
- 主要结局:静血疗效;次要结局:血栓事件,死亡率,停留时间.
主要成果:
- 包括71名患者;61名为心脏手术,10名为其他手术. 平均4F-PCC剂量:25.0单位/公斤.
- 81%的血液静止良好,但95.8%的人接受了4F-PCC后的血液制品.
- 14.1%的人经历了血栓栓塞事件;21.1%的死亡率.
结论:
- 4F-PCC在非抗凝血手术患者中显示出静血疗效,由血红蛋白/血红素位数变化证明.
- 观察到经常使用血液制品和显著的风险,包括DVT,PE和中风.
- 需要进一步的研究来验证在这个患者群体中非标签的4F-PCC给药.
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