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我应该在静脉静脉ECMO中更换抗凝剂吗?
Rabia Yılmaz1, Murat Arslan1, Deniz Özel Bilgi1
1University of Health Sciences Türkiye, Bakırköy Dr. Sadi Konuk Training and Research Hospital, Clinic of Anaesthesiology and Reanimation Critical Care, İstanbul, Türkiye.
Turkish journal of anaesthesiology and reanimation
|May 14, 2025
概括
比瓦利鲁丁在体外膜氧化 (ECMO) 患者的抗凝剂中与未分离的肝素同样有效. 这项研究没有发现疗效差异,但比瓦利鲁丁的使用与更低的输血需求和更高的成本有关.
科学领域:
- 关键护理医学 关键护理医学
- 心血管科学 心血管科学
- 药理学 药理学是指药理学的学科.
背景情况:
- 身体外膜氧化 (ECMO) 抗凝血缺乏标准化,高质量的数据,导致实践变化.
- 通常使用的是未分离的肝素 (UFH),但正在探索替代抗凝剂.
- 比瓦利鲁丁提供了直接的血栓抑制机制.
研究的目的:
- 在ECMO患者中调查比瓦利鲁丁与UFH的安全性,疗效和成本效益.
- 为了比较两种药物之间的使用激活部分血栓形成时间 (aPTT) 的抗凝血控制.
- 评估与每个抗凝剂相关的资源利用和成本.
主要方法:
- 追溯评估56名患者进行静脉静脉ECMO治疗急性呼吸困扰综合征.
- 在UFH治疗的25名患者和在bivalirudin治疗的31名患者之间的比较.
- 分析目标aPTT的时间,治疗范围内时间的百分比,输血需求和成本.
主要成果:
- 在bivalirudin和UFH组之间没有显著的时间差异来准aPTT或在治疗aPTT范围内的时间百分比.
- 与UFH组相比,比瓦利鲁丁组的红细胞悬浮和新鲜冷血替代物的中位数较低.
- 与UFH相比,与比瓦利鲁丁相关的成本显著更高.
结论:
- 比瓦利鲁丁在ECMO患者中显示出与UFH相比的抗凝效果.
- 比瓦利鲁丁的使用可能会减少对血液产品输血的需要.
- 比瓦利鲁丁的成本远远高于UFH.
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