在心脏重症监护病房中,不同连续脏置换系统和方式的血小板缺血的发生率
Jessica C Brumit1, Ryan A Caputo2, Sheila M Chucta3
1Department of Pharmacy, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
Journal of pharmacy practice
|November 21, 2024
概括
接受连续脏替代疗法 (CRRT) 的重症患者在使用NxStage系统 (CVVHD) 时,与Prismaflex系统 (CVVHDF) 相比,患血小板缩的发病率更高. 这一发现突显了CRRT相关的血小板缺血的模式差异.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 关键护理医学 关键护理医学
- 血液学 血液学 血液学
背景情况:
- 血小板缺血在重症患者中很常见,并且可能与连续脏替代疗法 (CRRT) 相关.
- 不同CRRT方式对血小板缺血发病率的影响尚不清楚.
研究的目的:
- 为了比较NxStage系统 (连续静脉血液透析 - CVVHD) 和Prismaflex系统 (连续静脉血液过 - CVVHDF) 之间的血栓缩发病率.
主要方法:
- 在美国一个学术医疗中心进行的回顾性队列研究.
- 包括2016年6月至2022年9月期间接受CRRT≥48小时的成年ICU患者.
- 在NxStage (CVVHD) 和Prismaflex (CVVHDF) 系统之间比较血小板缺血率.
主要成果:
- 147名患者符合纳入标准;61名患者接受了NxStage (CVVHD),86名患者接受了Prismaflex (CVVHDF).
- 血小板缺血发生在NxStage的57.4%,与Prismaflex的19.8%相比 (OR 5.46;95% CI,2.62-11.39),在调整后的模型中一致.
- NxStage组的血小板值较低,更多的HIT测试,直接使用血栓抑制剂和输血.
结论:
- 与Prismaflex (CVVHDF) 治疗的心血管ICU患者相比,接受NxStage (CVVHD) 治疗的心血管ICU患者患血小板缺血的发病率明显高.
- 选择CRRT方式可能会影响重症患者血小板缺血的风险.
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