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Jeremy Adderley¹, Tara Pidborochynski², Holger Buchholz³

¹Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.

|September 19, 2024

概括

比瓦利鲁丁抗凝剂和副体脉动 (PP) 腹腔辅助装置 (VAD) 降低了儿科患者发生血栓栓塞 (TE) 事件的风险. 体连续 (PC) VAD和肝素增加TE事件的风险.

科学领域:

儿童心脏病学儿童心脏病学
心血管外科心血管外科
生物医学工程生物医学工程

背景情况:

需要心室辅助器件 (VAD) 的儿科患者面临巨大的血栓栓塞 (TE) 并发症的风险.
优化抗凝策略和VAD选择对于改善这一脆弱人群的结果至关重要.

研究的目的:

为了确定与小儿VAD患者TE事件相关的因素.
评估初始抗凝策略和VAD类型对TE并发症率的影响.

主要方法:

从2005年到2022年,对儿科VAD患者进行了回顾性,单中心的审查.
包括患有副体脉动性 (PP),副体连续性 (PC) 或联合VAD的患者.
卡普兰-梅尔和考克斯的比例危险分析,以评估TE事件风险因素.

主要成果:

作为初始抗凝策略的比瓦利鲁丁与TE事件的危险性显著降低相关 (HR,0.30;P=.01).
与其他设备类型相比,体外脉动 (PP) VAD 显示了 TE 事件减少的趋势.
体连续 (PC) VAD策略独立地与TE事件的风险增加有关 (HR,2.78;P=.03).

结论:

最初使用比瓦利鲁丁的抗凝血剂和PP VADs的使用可能会降低儿科VAD接受者的TE事件风险.
PC VADs和初始肝素抗凝药与TE事件危险增加有关.
需要进一步的研究,以阐明VAD类型和小儿TE预防中的抗凝剂之间的相互作用.

关键词:

这是一种抗凝血药物.儿科儿科儿科有关风险因素的风险因素.血栓塞栓性血栓塞栓症是指发生血栓塞栓的情况.腹腔室辅助器件可以帮助心室.

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