导航凝血:儿科ECMO的前24小时的关键标志物
Jan V Stevens1, Katherine Regling2, Elika Ridelman1
1Department of Surgery, Division of Pediatric Surgery, Wayne State University/Children's Hospital of Michigan, Detroit, MI, USA.
Perfusion
|April 14, 2025
概括
纤维素水平是预测儿科外体膜氧化 (ECMO) 早期出血或凝血的关键. 监测基线和化后纤维素素有助于管理抗凝血和预防ECMO治疗儿童的并发症.
科学领域:
- 儿科重症监护医药 儿科重症监护医药
- 血液学 血液学 血液学
- 进行心血管外科手术.
背景情况:
- 儿童体外膜氧化 (ECMO) 抗凝剂是复杂的,由于发育性血液静止.
- 密切监测对于预防儿科ECMO患者出血和血栓事件至关重要.
- 关于传统凝血测试与儿科ECMO并发症之间的早期相关性数据有限.
研究的目的:
- 调查传统的凝血测试与儿童ECMO注射管后24小时内早期并发症之间的相关性.
- 确定用于预测儿科ECMO出血和血栓事件的关键实验室参数.
主要方法:
- 对126名接受ECMO治疗的儿童进行了回顾性评估 (2017年1月至2022年3月).
- 收集的取管前和后凝血参数:PTT,PT,INR,血红蛋白,血小板,纤维素原.
- 测量了初始ACT,目标ACT的时间,UFH输液速率和注射后的ATIII活动.
主要成果:
- 与更长的时间来准ACT,延长PT/INR,较低的纤维素原和较低的血小板计数相关的出血并发症.
- 血栓并发症与更高的前化纤维素水平有关.
- 纤维素原是出血和血栓事件的重要预测因素.
结论:
- 纤维素是评估儿科ECMO在前24小时内早期出血或血栓风险的关键参数.
- 基线和化后纤维素水平对于指导抗凝管理至关重要.
- 需要进一步的多中心研究来评估其他测试,如抗XA因子和粘弹性测试.
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