在患有急性肝衰竭的儿科患者中进行高体积血交换的新型抗凝策略
Amanda M Walker1,2, Kevin D Smith3,4, Joella L Slowik1
1Division of Pediatric Critical Care, Nemours Children's Hospital, Delaware, Wilmington, Delaware, USA.
Pediatric transplantation
|October 22, 2025
概括
高体积血交换 (HVPE) 对儿科急性肝衰竭是安全的. 结合酸盐和肝素抗凝剂可减少酸盐锁定并发症,而不会增加出血风险,有助于恢复或移植.
科学领域:
- 儿科 儿科 儿科
- 肝病学 肝病学是一种肝病学.
- 关键护理医学 关键护理医学
背景情况:
- 儿科急性肝衰竭 (PALF) 呈现出显著的发病率和死亡率.
- 高容量血交换 (HVPE) 是PALF患者的重要血液净化技术,可使肝脏移植或恢复的生存.
- 目前的HVPE协议需要优化的抗凝血策略.
研究的目的:
- 在儿科急性肝衰竭患者中描述使用酸盐和肝素治疗HVPE的新型抗凝血方案.
- 在HVPE期间评估这种联合抗凝策略的安全性和有效性.
主要方法:
- 对接受HVPE的急性肝衰竭儿科患者 (<18岁) 的回顾性评估.
- 对抗凝血方案的分析,重点是仅酸盐与酸盐加氨酸.
- 对不良事件的评估,包括出血,酸盐锁定,低血压和低温.
主要成果:
- 分析了11名儿科患者的12次HVPE遭遇.
- 转换为酸盐加肝素显著减少了酸盐锁定发生率,从80%降至25% (或0.083).
- 没有观察到出血并发症或危及生命的不良事件;44%的治疗中发生了非严重事件.
结论:
- HVPE是儿童急性肝衰竭的安全和耐受性治疗方法,作为移植或恢复的桥梁.
- 在HVPE期间添加酸盐抗凝剂的氨酸有效降低了酸盐锁定频率.
- 综合抗凝策略提高了小儿急性肝衰竭的HVPE安全性,而不会增加出血风险.
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