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纤维素缩剂补充剂对接受复杂心脏手术的婴儿手术后出血的作用
Alessandra Rizza1, Carola Pergolizzi2, Simona Benegni3
1Pediatric Cardiac Intensive Care Unit, Department of Cardiology and Cardiac Surgery, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy. alessandra.rizza@opbg.net.
Pediatric cardiology
|July 9, 2024
概括
纤维素缩物 (FC) 可能有助于在接受复杂心脏手术的婴儿中控制出血. 虽然在统计学上不显著,但FC显示出减少出血和改善纤维素水平的趋势,副作用与标准治疗相比相当.
科学领域:
- 儿科心脏手术 儿科心脏手术
- 患者血液管理患者血液管理
- 血液静止 血液静止 血液静止
背景情况:
- 在儿科心脏外科手术中输入异构血液产品存在重大风险.
- 纤维素缩物 (FC) 是缓解血静的有希望的替代品,但缺乏儿科指导方针.
- 在儿科实践中对FC的客观临床评估很少.
研究的目的:
- 为了评估额外纤维素缩物 (FC) 在接受复杂心脏手术和心肺旁路手术的婴儿的静血效应.
- 评估FC对持续性,临床相关出血的影响.
- 为了确定功能性低纤维素生成血的值和术后的结果.
主要方法:
- 对139名婴儿 (<2岁) 进行了回顾性单中心研究,这些婴儿接受了心肺绕道心脏手术.
- 患者接受了FC补充剂或进一步的新鲜冷血 (FFP) 输血,以治疗持续的出血.
- 主要终点:FC的静血效应. 二级终点:MA-Fib,纤维素生成血,输血,不良事件.
主要成果:
- FC组有较长的体外循环和大动脉交叉紧时间,较低的最低温度,以及更多地使用其他血液制品和胺酸.
- 术后出血和严重出血率在各组之间没有统计学上的差异 (p=0.786和p=0.695),但观察到CF出血减少的趋势 (p=0.064).
- 与FFP相比,FC组显示出更高的术后最大幅度纤维素原 (MA-Fib) 和纤维素原血症 (p=0.003和p<0.001).
结论:
- 纤维素缩物 (FC) 可能在复杂的儿科心脏手术期间在控制出血方面发挥作用.
- 补充FC显示了减少术后出血和改善纤维素素水平的趋势.
- FC组的不良事件与不那么复杂的手术中的不良事件相似,这表明了有利的安全概况.
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