在肝脏手术患者中使用抗XA因子水平的预防性埃诺沙巴林剂量:试点研究
Samuel Coster1, Ali Shammout1, Michael Chaney1
1Department of General Surgery, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI, USA.
The American surgeon
|March 15, 2024
概括
在肝脏手术患者的静脉血栓塞栓症 (VTE) 降低的基于高峰抗Xa水平的向素剂量. 这种方法被证明是安全的,没有增加出血并发症,提供了一种新的预防策略.
科学领域:
- 肝胆道手术 肝胆道手术
- 药理学 药理学是指药理学的学科.
- 预防血栓形成的预防方法
背景情况:
- 肝脏手术带来了静脉血栓栓塞 (VTE) 的风险.
- 标准的埃诺沙巴林剂量可能无法优化这种患者群体的预防.
- 监测抗Xa水平可以指导抗凝固疗法.
研究的目的:
- 为了评估使用高峰抗Xa水平来指导VTE预防的埃诺沙巴林剂量的安全性和有效性.
- 为了在肝脏手术患者中比较向和标准氧沙预防之间的VTE率和出血事件.
主要方法:
- 接受肝脏手术的患者接受素调整至高峰抗Xa水平 (≥0.20 U/ml) 的患者的未来招募.
- 与接受标准VTE化疗的历史队列进行比较.
- 评估住院患者的术后静脉瘤发生率,输血,血红蛋白水平和出血事件.
主要成果:
- 与标准预防组相比,向素组的住院术后静脉瘤发病率明显较低 (0%对8.16%,P=.035).
- 两组之间在术后输血,出院血红蛋白或医院内出血事件中没有显著差异.
- 达到高峰抗Xa水平≥0.20 IU/ml与静脉瘤减少而没有增加出血有关.
结论:
- 调整埃诺沙巴林剂量以达到≥0.20 IU/ml的预防性高峰抗Xa水平,有效地减少了症状性住院患者的术后静脉动脉.
- 这种有针对性的方法对于接受肝脏手术的患者来说是安全的,因为它不会增加术后出血.
- 峰值抗Xa水平监测为优化肝脏手术中的埃诺沙巴林预防提供了有价值的策略.
相关概念视频
Anticoagulant Drugs: Low-Molecular-Weight Heparins
692
Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
692
Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants
1.2K
Oral anticoagulants are vital tools in preventing and treating blood clotting disorders. This diverse class of medications can be categorized as vitamin K antagonists, exemplified by warfarin, and direct thrombin inhibitors (DTIs), such as dabigatran, as well as factor Xa inhibitors, including rivaroxaban.
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
1.2K
Renal Failure: Dose Adjustments
88
In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
88
Antiplatelet Drugs: Prostaglandin Synthesis, P2Y12 and Glycoprotein IIb/IIIa Inhibitors
522
Antiplatelet drugs emerge as frontline defenders against the insidious threat of thromboembolic diseases, where abnormal clots obstruct vital blood vessels. These drugs stand as bulwarks, inhibiting platelet aggregation and clot formation, thereby mitigating the risk of life-threatening conditions like myocardial infarction, coronary artery disease, and thrombotic strokes.
Prostaglandin synthesis inhibitors, exemplified by the widely known aspirin, wield their power by irreversibly acetylating...
Prostaglandin synthesis inhibitors, exemplified by the widely known aspirin, wield their power by irreversibly acetylating...
522
Therapeutic Index
4.2K
The therapeutic index of a drug is a key parameter in pharmacology that quantifies the relative safety of a drug by calculating the ratio between the dose that causes toxicity in half the population (50%) to the dose that proves to be effective for half the population (50%). It provides a spectrum of doses for a particular drug ranging from effective to potentially toxic. To illustrate, consider an anticoagulant agent like warfarin. It possesses a narrow window within its therapeutic index to...
4.2K
Dosage Regimen: Fixed Dose
1.9K
Fixed-dose regimens are a common approach to administer drugs to achieve and maintain desired levels of the drug in the body. In this dosing strategy, a specific amount of medication is given at regular intervals, often multiple times a day, to ensure a consistent drug concentration in the bloodstream.
Fixed-dose regimens can be used for various routes of administration, including intravenous (IV) injections and oral medications. For IV administration, a predetermined amount of the drug is...
Fixed-dose regimens can be used for various routes of administration, including intravenous (IV) injections and oral medications. For IV administration, a predetermined amount of the drug is...
1.9K


