在澳大利亚单一中心对创伤患者进行化学静脉血栓栓塞预防的评估
Natalie Quarmby1, Minh Tu Vo1, Sean Weng Chan2
1Department of Surgery, Canberra Hospital, Garran, ACT, Australia.
Journal of trauma and injury
|October 21, 2024
概括
一定剂量的埃诺沙巴林在25%的创伤患者中提供了亚治疗性静脉血栓塞栓症预防. 患者体重较高与剂量不足相关,这表明基于体重的预防可能更有效.
科学领域:
- 创伤护理的护理人员.
- 药理学 药理学是指药理学的学科.
- 临床医学 临床医学
背景情况:
- 创伤患者面临高静脉血栓栓塞 (VTE) 风险,在ICU环境中死亡率显著 (25-38%).
- 在创伤中进行VTE预防的临床实践是不一致的,由于禁忌.
研究的目的:
- 在澳大利亚中心对创伤患者进行目前化学静脉瘤预防的有效性进行评估.
- 通过使用抗Xa因子 (aFXa) 水平来评估VTE预防的充分性.
主要方法:
- 在2022年7月至11月接受低分子量肝素 (乙诺沙巴林) 的创伤患者 (≥18岁) 的前性审查.
- 纳入标准:抗凝药没有禁忌,≥3剂埃诺沙巴林,随后进行aFXa水平测试.
主要成果:
- 在被纳入的63名患者中,有47人达到治疗性aFXa水平,而16人 (25%) 则是次治疗性.
- 在次治疗组中,体重增加是唯一显著的差异 (91.9公斤与79.1公斤相比;P<0.05).
结论:
- 固定剂量素治疗方案导致25%的创伤患者接受了亚治疗性静脉瘤预防.
- 较高的患者体重与不足的埃诺沙巴林剂量有关.
- 低分子量赫巴林的基于体重的剂量可能会改善创伤患者的静脉瘤预防的有效性.
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