ECMO在肺移植期间通过PFA-200检测到的初级血液静止发生非常快速的变化:一项观察性研究
Michal Garaj1, Alessandro Francesconi2, Miroslav Durila1
1Department of Anesthesiology and Intensive Care Medicine, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic.
概括
身体外膜氧化 (ECMO) 支持导致一次性静血病理. 这种疾病在ECMO停止后迅速消失,正如PFA-200检测到的那样,尽管血小板功能持续不良.
科学领域:
- 心血管研究研究心血管研究
- 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:
- 初级静血病态是体外膜氧化 (ECMO) 的常见并发症.
- 关于短期ECMO期间的血液静止变化和功能恢复的数据有限.
- 了解ECMO对初级血液静止的影响对于患者管理至关重要.
研究的目的:
- 调查短期ECMO诱导的原发性血液静止病理.
- 评估ECMO期间和之后血液静止功能的时间变化.
- 为了评估PFA-200的实用性,ROTEM血小板检测和·维勒布兰德因子 (vWF) 分析.
主要方法:
- 分析了肺移植期间接受静脉动脉ECMO治疗的32名患者的血液样本.
- 使用的血小板功能分析仪-200 (PFA-200) 配有原蛋白/上腺素,原蛋白/ADP和原蛋白/P2Y12弹.
- 评估ROTEM血小板功能,vWF抗原,瑞斯托辅因子 (RCo) 和原结合蛋白 (CB) 水平.
主要成果:
- 所有的PFA-200试验都显示在ECMO期间出现了显著的恶化,停止后恢复迅速 (p < 0.05).
- 在ECMO停止后,观察到vWF抗原的显著增加 (p < 0.05).
- 在ECMO后,ROTEM血小板检测表明持续的功能障碍,而RCo和CB水平显示非显著的增加.
结论:
- 短期的ECMO支持会诱导一次性静血障碍,并立即表现出来.
- 这种ECMO诱导的病理在ECMO停止后迅速可逆,可以通过PFA-200检测到.
- 经ECMO后vWF抗原水平升高可能会导致正常的初级血静检测结果,尽管ROTEM检测了血小板功能障碍.
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