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旋转血栓等离子仪在患有传染性内心炎的患者中进行心脏动手术的独特特征:回顾性倾向得分匹配的观察性研究
Stanislaw Vander Zwaag1, Imre Kukel1, Kinga Towarek-Nocon2
1Department of Cardiac Anesthesiology, Medical Faculty and Heart Center Dresden, TUD Dresden University of Technology, Dresden, Germany.
概括
接受心脏手术的传染性内心炎患者表现出明显的凝血模式,凝血时间更长,凝血度增加. 这就需要更多地使用前热血素复合缩物 (PCC) 来控制出血风险.
科学领域:
- 心血管外科心血管外科
- 血液学 血液学 血液学
- 麻醉学 麻醉学
背景情况:
- 血液静止系统与膜植被和感染性内心炎中的凝血异常有关.
- 接受膜手术的内心炎患者存在复杂的凝血挑战.
- 旋转性血栓形成显微镜 (ROTEM) 是一种评估凝血的临床检测.
研究的目的:
- 通过使用ROTEM在心脏手术期间研究内心炎患者凝血的独特粘弹性特性.
- 为了比较内心炎患者和接受膜手术的匹配对照组之间的ROTEM发现.
- 评估内心炎对血液产品输血需求的影响.
主要方法:
- 在2022年5月至2024年8月期间对膜手术患者的回顾性分析.
- 在体外循环和肝素逆转后进行的ROTEM评估.
- 倾向性得分匹配用于创建内心炎组和对照组 (每组23名患者).
主要成果:
- 与对照组相比,内心炎患者表现出延长的EXTEM凝血时间 (136s vs 96s) 和更高的FIBTEM-A5凝血度 (19mm vs 13mm).
- 内心炎患者需要显著更多的前列红素复合缩物 (PCC) (3000对2500单位).
- 在血小板,新鲜冷血 (FFP) 或纤维素缩物 (FC) 的输血中,在两组之间没有发现显著差异.
结论:
- 内心炎患者表现出明显的ROTEM形状,其特点是凝血延长和凝血结度增加.
- 这些发现表明,在接受膜手术的内心炎患者中,需要增加PCC补充剂.
- 需要进一步的研究来优化ROTEM参数,以平衡该人群中出血和血栓风险.
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