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在静脉外体膜氧化过程中连续与中断抗凝血的血栓栓塞并发症:一个多中心研究
William Miller1, Jacob Braaten1, Anna Rauzi1
1Department of Surgery, University of Minnesota, Minneapolis, MN.
Critical care explorations
|September 26, 2024
概括
在毒性体外膜氧化 (ECMO) 期间中断的抗凝血不增加血栓事件. 然而,更频繁或更长时间的中断与更高的血栓事件率有关.
科学领域:
- 关键护理医学 关键护理医学
- 心血管研究研究心血管研究
- 血液学 血液学 血液学
背景情况:
- 持续的治疗性抗凝剂是体外膜氧化 (ECMO) 的标准.
- 在ECMO患者中,平衡出血风险与血栓风险至关重要.
- 毒性ECMO需要仔细管理抗凝血药物,以防止并发症.
研究的目的:
- 测试假设中断的抗凝剂会增加有毒ECMO患者的血栓事件.
- 为了比较中断和连续抗凝剂组之间的血栓并发症率.
- 调查抗凝血中断频率和持续时间对血栓事件的影响.
主要方法:
- 在三个成年ECMO中心 (2013-2022) 进行了回顾性观察性研究.
- 包括346名接受毒性ECMO治疗的患者.
- 从电子健康记录中收集了抗凝血药物管理数据,记录了中断,血栓事件和ECMO电路变化.
主要成果:
- 156名患者中断了抗凝剂 (IA),190名患者接受了持续的抗凝剂.
- 在统计学上,IA与增加的血栓性并发症 (OR,0.69) 或ECMO电路变化 (OR,1.36) 无关.
- 增加IA的频率和持续时间与更高的整体血栓事件频率相关 (p = 0.001).
结论:
- 多中心分析显示,ECMO患者中断抗凝剂与持续抗凝剂的血栓事件频率相似.
- 需要进行进一步的研究,以了解抗凝血中断频率和持续时间对抗凝血药物的具体影响.
- 在ECMO期间优化抗凝策略仍然是临床研究的一个领域.
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