离心与基于过的细胞挽救:对心脏外科手术中术后出血的影响 - - COLTRANE随机临床试验 - - 研究方案
Antoine Beurton1,2, Alexandre Mansour3, Antoine Benard4
1Department of Cardiovascular Anesthesia and Critical Care, CHU Bordeaux, Haut-Lévêque hospital, Bordeaux, France antoine.beurton@chu-bordeaux.fr.
BMJ open
|July 16, 2025
概括
这项研究将一种新的基于过的自输装置与高风险心脏手术患者的传统离心法进行比较. 目标是减少显著的外科手术期间出血,并改善患者的治疗结果.
科学领域:
- 心血管外科心血管外科
- 输血医学 输血医学
- 关键护理医学 关键护理医学
背景情况:
- 心脏手术带有高出血风险,即使是先进的患者血液管理.
- 传统的自输血装置主要恢复红细胞,失去重要的血小板和凝固因子.
- 这种新的基于过的SAME设备旨在恢复红细胞,白细胞和血小板,以改善外科手术期间的血液静止.
研究的目的:
- 为了确定基于过的SAME自输装置是否与基于离心系统相比减少了显著的外科手术期间出血.
- 评估SAME设备在高风险心脏手术患者中的有效性和安全性.
主要方法:
- 一个多中心,优越性随机临床试验 (COLTRANE) 涉及570名高风险心脏手术患者.
- 随机分配给以离心或过为基础的自输血的患者.
- 主要结局:患有显著外科手术期间出血的患者比例 (通用定义二至四类).
主要成果:
- 主要结果数据尚未提供,因为研究仍在进行中.
- 二次结果包括设备的效率,安全性,静血,ICU/住院,发病率和死亡率.
- 辅助研究将评估细胞恢复,血液粘性弹性和白细胞对炎症的影响.
结论:
- 科尔特兰试验将提供关键数据,以过为基础的自输在高风险心脏手术期间减少出血的疗效.
- 预计结果将为术后血液管理和患者安全的最佳实践提供信息.
- 研究结果将通过科学会议和同行评审的出版物传播.
相关概念视频
Extracorporeal Removal of Drugs: Hemoperfusion and Hemofiltration
375
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...
375
Extracorporeal Removal of Drugs: Continuous Renal Replacement Therapy
414
Continuous Renal Replacement Therapy (CRRT) is an essential intervention for patients experiencing severe kidney dysfunction. This therapy offers a continuous mechanism for removing fluids and toxins from the bloodstream, leveraging the patient’s blood pressure to facilitate filtration through a specialized filter. This method contrasts with intermittent dialysis, providing a gentler and more consistent removal of waste products and excess fluid, which is particularly beneficial in...
414
Cardiomyopathy VII: Pre and Post Operative Nursing Management
460
Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
460


