在隔离严重创伤性脑损伤后的急性时期,基于静脉血栓栓塞的基于血栓显微镜的预防
Anastasia I Baranich1, Aleksandr A Sychev1, Ivan A Savin1
1Neurocritical Care Department, N.N. Burdenko National Medical Research Center of Neurosurgery of the Ministry of Health of the Russian Federation, Moscow, Russian Federation.
Korean journal of neurotrauma
|April 5, 2024
概括
在严重创伤性脑损伤 (TBI) 患者中,早期静脉瘤预防 (3-4天) 是安全的. 旋转性血栓形成仪 (ROTEM) 有助于识别高凝血,优化治疗时间和降低风险.
科学领域:
- 神经创伤是一种神经创伤.
- 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:
- 创伤性脑损伤 (TBI) 显著增加了静脉血栓栓塞 (VTE) 的风险.
- 在严重的TBI患者中确定VTE预防的最佳时间对于患者的安全至关重要.
研究的目的:
- 确定在单独严重TBI患者中启动药理性VTE血栓预防的理想时间.
- 为了利用旋转性血栓形成显微镜 (ROTEM) 来指导VTE预防决策.
主要方法:
- 一项观察性研究涉及115名成年患者,在受伤后48小时内患有单独的严重TBI.
- 旋转性血小板测量 (ROTEM) 用于评估高凝血,特别是凝血密度 (MCF EXTEM) 和纤维素素水平 (MCF FIBTEM).
- 开始VTE化学预防的时间与脑CT关于出血进展的发现相关.
主要成果:
- 过高凝血,表示MCF EXTEM和MCF FIBTEM升高,在第7天 (85.2%) 显著部分患者中观察到.
- 在TBI后3-4天开始的早期VTE化疗预防没有导致患者的出血焦点的进展.
- ROTEM发现了高凝血,这表明了潜在的干预窗口.
结论:
- 旋转性血小板造影仪 (ROTEM) 在严重的TBI中对管理VTE风险具有临床意义.
- 在严重的TBI后3-4天开始抗凝剂预防似乎是安全的,出血进展的风险最小.
- 这项研究提供了数据,以优化TBI患者的VTE化疗预防策略,潜在地减少并发症.
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