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在连续脏置换疗法期间进行协议化的区域酸盐抗凝剂:单一中心体验
Anant V Pachisia1, G Praveen Kumar2, Rahul Harne1
1Institute of Critical Care and Anesthesia, Medanta - The Medicity, Gurugram, Haryana, India.
概括
区域酸盐抗凝药 (RCA) 为连续脏替代疗法 (CRRT) 提供了一种安全的方法,可降低出血和过凝血风险. 这项研究评估了一种新的RCA协议,发现它在重症患者中有效.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 关键护理医学 关键护理医学
- 心血管系统 心血管系统
背景情况:
- 区域酸盐抗凝药 (RCA) 越来越多地用于连续置换疗法 (CRRT),以尽量减少出血和过凝血.
- 基于现有文献和初步临床经验,开发了CRRT期间RCA的工作协议.
研究的目的:
- 评估标准化RCA协议在CRRT中常规使用的有效性和安全性.
- 评估RCA协议对过器寿命和抗凝效果的影响.
主要方法:
- 一个单中心,前性,观察性研究,涉及159名需要CRRT的成年患者.
- 患者使用带有AN 69透析器的Prisma Flex机器进行连续毒脉血过 (CVVHDF).
- 实施了一种协议化的RCA管理策略,目标是CRRT剂量为25-30毫升/公斤/小时.
主要成果:
- 过器的平均寿命为30小时,在33.3%的患者中发生过器凝血.
- 在52.25%的患者中观察到酸盐积累,但在没有停止CRRT或毒性的情况下可以控制.
- 酸盐积累增加与慢性肝病和活体供体肝移植后状态以及较高的基线乳酸盐水平显著相关.
结论:
- 开发的RCA协议是一种安全有效的方法,用于在接受CRRT的重症患者中进行抗凝血治疗.
- 该协议允许成功管理酸盐积累,防止治疗中断.
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