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炎症和抗血素补充剂在静脉ECMO呼吸衰竭静脉ECMO期间对血栓结膜学参数的作用

Andrea Meli¹, Stefano De Falco¹, Cristina Novembrino²

¹Department of Anesthesiology, Critical Care and Emergency, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.

|April 23, 2024

概括

在体外膜氧化 (ECMO) 过程中的全身炎症可能会影响凝血监测测试. 抗血素 (AT) 补充剂可能会改变这些结果,影响重症患者的抗凝管理.

科学领域:

关键护理医学关键护理医学
血液学血液学血液学
免疫学免疫学免疫学

背景情况:

身体外膜氧化 (ECMO) 可以诱导系统性炎症.
在ECMO期间的细胞因子释放可能会干扰用于抗凝血监测的血栓凝血学 (TEG).
补充抗血素 (AT) 是一种潜在的干预措施,可能进一步影响TEG结果.

研究的目的:

在接受ECMO的患者中研究系统性细胞因子和TEG参数之间的关系.
评估AT补充剂对这种关系的影响.

主要方法:

一项随机对照试验的子研究,涉及成年患者接受毒性ECMO (vv-ECMO).
患者接受了AT补充剂或标准治疗,使用未分离的肝素 (UFH).
在多个时间点收集血样本进行细胞因子分析 (IL-8,IL-10,IL-6,IL-1β,TNF-α,Pro-ADM) 和TEG测量.

主要成果:

较高的细胞因子水平与改变的TEG参数存在相关性,表明炎症诱导的低凝度.
TEG-R,TEG-ANG和TEG-MA与各种细胞因子相关.
补充AT似乎改变了TEG-MA和某些细胞因子 (IL-8,IL-10,Pro-ADM) 之间的关联.

结论:

在ECMO期间系统性炎症的增加与TEG检测到的低凝度有关.
细胞因子度与特定的TEG变量相关,反映了炎症对凝血的影响.
补充AT可以调节炎症对特定TEG参数的影响,但不是全部.

关键词:

身体外膜氧化器的氧化抗血素是一种抗血素.这是一种炎症炎症炎症炎症.互乐金是一种介质蛋白.血小板结晶学血小板结晶学血小板结晶学

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