抗凝药可以在受伤患者的静脉-静脉外体膜氧化支持下进行
Erin Niles1, Rishi Kundi2, Thomas Scalea2
1From the Critical Care Resuscitation Unit, R Adams Cowley Shock Trauma Center, Baltimore, Maryland.
概括
在静脉静脉外体氧化 (VV ECMO) 的创伤患者中,扣留抗凝剂是安全的. 这种方法没有增加死亡率或并发症,这表明更广泛的利用是可能的.
科学领域:
- 关键护理医学 关键护理医学
- 创伤外科 手术 创伤外科
- 肺部医学 肺部医学
背景情况:
- 创伤伤害可以导致严重的肺部并发症,如ARDS.
- 静脉静脉外体氧化 (VV ECMO) 是呼吸衰竭的生命支持选择.
- 关于VV ECMO在创伤患者中使用的数据有限,特别是关于抗凝药.
研究的目的:
- 评估在创伤患者中扣留抗凝药的安全性,支持VV ECMO.
- 评估持有抗凝药对死亡率和血栓性并发症的影响.
- 在VV ECMO患者中描述与创伤相关的凝血病.
主要方法:
- 单中心回顾性队列研究.
- 成年创伤患者在2014-2021年期间接受了VV ECMO的管治疗.
- 接受和不接受抗凝药的患者之间的结局的比较.
主要成果:
- 暂停抗凝药与死亡率的增加没有关联.
- 没有观察到出血或凝血并发症的显著差异.
- 非幸存者在取管前和后表现出更大的凝血病.
结论:
- 在遭受创伤的VV ECMO患者中,可以安全地停止抗凝药.
- 这种做法可能不会增加死亡率,并发症或输血需求.
- 需要进一步的多中心前性研究来验证这些发现.
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