治疗性血交换用于纤维素因子相关的高粘度:COVID-19 PLasma EXchange (COPLEX) 随机对照试验的结果
Cheryl L Maier1, Hirotomo Nakahara2, Nicholas A Barker3
1Department of Pathology and Laboratory Medicine, Emory School of Medicine, Atlanta, Georgia, USA.
Journal of thrombosis and haemostasis : JTH
|January 2, 2025
概括
治疗性血交换 (TPE) 在重症COVID-19患者中安全地降低了血液粘度. TPE使粘度正常化并降低了炎症标志物,尽管它对死亡率的影响需要进一步研究.
科学领域:
- 关键护理医学 关键护理医学
- 血液学 血液学 血液学
- 心血管生理学心血管生理学
背景情况:
- 治疗性血交换 (TPE) 是由于高型球蛋白血症导致的超粘度的标准.
- 它在高纤维素生成血症引起的高粘度中的有效性仍然不确定.
- 危急的COVID-19患者经常出现高纤维素生成血症和血液粘度升高.
研究的目的:
- 为了评估TPE在重症COVID-19患者的安全性和有效性,这些患者由于高纤维素生成血症而经历血粘度升高.
主要方法:
- 进行了一项前性随机对照试验.
- 患有高纤维蛋白质血症或血粘度升高的重症COVID-19患者被随机分组.
- 干预包括连续两天的TPE或标准护理 (SOC).
主要成果:
- 与SOC相比,TPE显著降低了血粘度和纤维素素水平.
- 炎症和内皮激活的生物标志物被TPE减少.
- 与TPE没有报告任何严重的安全事件;死亡率差异在统计学上并不显著.
结论:
- TPE是一种安全有效的治疗方法,用于在COVID-19患者中正常化高血粘度.
- 需要进一步的研究来确定TPE对患者结果的影响,包括非COVID-19高纤维素生成症的情况.
相关概念视频
02:45Blood Transfusion and Agglutination
Blood transfusion is a therapeutic measure to restore the blood volume after extensive blood loss due to an accident or a medical procedure. Blood transfusion involves drawing a certain amount of blood from a suitable donor and infusing it into the recipient.
History
The history of blood transfusion dates back to the 17th century, when early attempts were made in animals. In 1818 James Blundell, a British doctor, performed the first successful human blood transfusion. Later in 1900, Karl...
History
The history of blood transfusion dates back to the 17th century, when early attempts were made in animals. In 1818 James Blundell, a British doctor, performed the first successful human blood transfusion. Later in 1900, Karl...
01:16Clot Retraction and Fibrinolysis
After a fibrin clot is formed, the next step is clot retraction, a vital process facilitated by platelet contractile proteins, such as actin and myosin. These proteins pull the fibrin strands closer together and condense the clot. This action reduces the size of the clot, creating a smaller, denser structure that effectively seals off the damaged vessel. Clot retraction consolidates the clot and helps with wound healing by bringing the edges of the damaged blood vessel closer together.
01:25Extracorporeal Removal of Drugs: Hemoperfusion and Hemofiltration
Hemoperfusion and hemofiltration are critical techniques in medical treatments to eliminate accumulated drugs, metabolites, and electrolytes from the bloodstream. These methods are particularly vital in cases of accidental poisoning and drug overdose.Hemoperfusion involves passing blood through an adsorbent material to remove unwanted substances. The main adsorbents used in hemoperfusion include activated charcoal and Amberlite resins. Activated charcoal can adsorb both polar and nonpolar...
01:29Venous Thrombosis III: Interprofessional Care
Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...