药物学静脉血栓塞栓症预防在患有非创伤性脑下垂体出血需要外腔室排水的患者
Chidozie Ukpabi1, Ofer Sadan2, Yuyang Shi3
1Department of Clinical Pharmacy, Emory Healthcare, Atlanta, GA, USA. Chidozie.ukpabi@emoryhealthcare.org.
Neurocritical care
|May 10, 2024
概括
在带有外部心室排水的脑下下垂层出血患者中预防血栓的最佳剂量尚不清楚. 这项研究发现,埃诺沙巴林,肝素或没有预防的VTE或ICH率之间没有显著差异.
科学领域:
- 神经科学是一个神经科学.
- 药理学 药理学是指药理学的学科.
- 临界护理医学 临界护理医学
背景情况:
- 在患有下arachnoid出血 (SAH) 和外部心室排水 (EVD) 的患者中,药物学血栓预防的最佳剂量没有得到很好的描述.
- 接受预防性埃诺沙巴林的SAH和EVD患者通过定时抗Xa水平进行例行监测.
研究的目的:
- 确定静脉血栓栓塞 (VTE) 和二次内出血 (ICH) 的发生频率.
- 评估EVD的SAH患者使用埃诺沙巴林或未分离肝素 (UFH) 的药理预防.
主要方法:
- 在埃默里大学医院 (2012-2017) 的需要EVD的SAH患者的回顾性图表审查.
- 包括接受素,UFH或没有药物预防的患者.
主要成果:
- 静脉瘤发生在7.5% (素),4.4% (UFH) 和3.2% (没有预防) 的患者中.
- 二次性ICH发生在3.83% (素),3.51% (UFH) 和3.94% (没有预防) 的患者中.
- 较高的抗Xa水平显示了较低VTE的趋势,但与ICH没有相关性;埃诺沙巴林和UFH都没有显著减少VTE或增加ICH.
结论:
- 在EVD的SAH患者中,在ENOXAPARIN,UFH之间没有观察到VTE或二次ICH发病率的统计学上显著差异,也没有观察到VTE预防.
- 与埃诺沙巴林的稳定状态抗Xa水平较高可能与较低的VTE发病率相关,而不会增加ICH风险.
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