与内血管冷却导管相关的下腔静脉血栓形成:对临床结果的影响
Morgane Laverdure1, Derek So1, Aun Yeong Chong1
1University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, Ontario K1Y 4W7, Canada.
Resuscitation
|August 22, 2025
概括
下腔静脉血栓 (IVC) 是用于治疗低温的内血管冷却导管的并发症. 虽然它不会影响死亡率,但会增加出血风险,并且需要长期使用抗凝剂.
科学领域:
- 心脏病学
- 危急护理医学
- 血管外科
背景情况:
- 血管内冷却导管对于在重症监护机构诱导治疗性低温至关重要.
- 与这些导管相关的并发症,特别是下腔静脉 (IVC) 血栓形成,需要彻底调查.
- 了解IVC血栓的发生率和影响对于治疗低温方案中的患者安全至关重要.
研究的目的:
- 确定治疗性低温后心脏骤停 (OHCA) 患者的IVC血栓形成的频率.
- 评估IVC血栓形成对死亡率和神经结果的临床影响.
- 评估相关并发症,如出血和长期使用抗凝剂.
主要方法:
- 对参与367名OHCA幸存者随机分类为轻度或中度低温的CAPITAL- CHILL试验的后期分析.
- 患者使用内血管冷却导管进行治疗,并通过腹部超声波检查常规查IVC血栓.
- 在IVC血栓形成的患者和没有IVC血栓形成的患者之间对结果进行比较,重点是180天后死亡或神经结果不佳.
主要成果:
- 在分析的319名患者中,6. 6% 患有IVC血栓形成.
- 两组之间没有观察到主要结果 (死亡或神经结果差) 的显著差异 (47.6%与38. 3%,P=0. 39).
- 患有IVC血栓的患者在住院出血率较高 (33. 3% vs 22. 8%,P=0. 24),并且在服用抗凝药时出院的可能性更高 (76. 9% vs 22. 5%,P< 0. 0001).
结论:
- 下腔静脉血栓是内血管冷却的显著并发症,即使使用抗凝药.
- 这种并发症似乎不会增加死亡或神经系统不良结果的风险.
- 静脉血栓与医院内出血增加有关,并且在出院后需要长期抗凝药治疗的可能性更高.
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