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在重症儿童的连续脏替代疗法期间,酸盐抗凝药和全身肝素抗凝药
Seyma Koksal Atis1, Muhterem Duyu2, Zeynep Karakaya3
1Department of Pediatrics, Istanbul Goztepe Prof. Dr. Suleyman Yalcin City Hospital, Istanbul, Turkey. dr.seymakoksalatis@gmail.com.
区域酸盐抗凝药 (RCA) 是重症儿童连续替代疗法 (CRRT) 的安全有效方法,与肝素相比,延长血过器存活时间. 这种方法最大限度地减少了电路停机时间,并提供了潜在的成本节省.
科学领域:
- 儿科重症监护医药 儿科重症监护医药
- 腎臟病學 (nephrology) 是一種醫學專業.
- 麻醉学 麻醉学
背景情况:
- 持续置换疗法 (CRRT) 对患有衰竭的重症儿童至关重要.
- 抗凝剂对于保持CRRT电路通透性至关重要.
- 肝素和区域酸盐抗凝剂 (RCA) 是常见的抗凝剂策略.
研究的目的:
- 为了比较RCA与全身肝素在CRRT期间的抗凝药的疗效和安全性,在重症儿童中.
- 为了评估血过器存活时间和相关并发症.
主要方法:
- 对接受CRRT的重症儿童进行了回顾性比较队列研究.
- 患者接受了RCA或全身肝素抗凝药.
- 主要结局:血过器生存时间. 二次结果:并发症和代谢障碍.
主要成果:
- 与肝素 (29.5小时) 相比,RCA (51.0小时) 的血过器存活时间显著更长 (p=0.002).
- 与凝血相关的血过器衰竭在RCA (9.6%) 与肝素 (19.6%) (p=0.038) 相比较低.
- 酸盐积累发生在3.5%的RCA疗程中;低血症和代谢性与RCA更频繁.
结论:
- 区域酸盐抗凝药是一种安全有效的抗凝方法,用于重症儿童的CRRT.
- 与全身肝素相比,RCA延长了血过器的存活时间,并减少了与凝血有关的失败.
- RCA可以最大限度地实现CRRT交付,通过减少电路停机时间,潜在地节省成本.
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