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中枢静脉导管功能障碍和静脉血栓栓塞风险的血栓溶解灌注在重症儿童中
Anthony A Sochet1,2, Minh Q Le2, Neil A Goldenberg2,3,4,5
1Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Johns Hopkins All Children's Hospital, St. Petersburg, Florida.
Seminars in thrombosis and hemostasis
|October 30, 2025
概括
血栓溶解剂经常用于恢复儿童中枢静脉导管 (CVC) 功能. 然而,它们的使用与在医院获得的静脉血栓塞栓症 (HA-VTE) 的风险更高有关.
科学领域:
- 儿科重症监护医药 儿科重症监护医药
- 血管接触并发症 血管接触并发症
- 血栓塞栓性疾病的管理管理
背景情况:
- 中枢静脉导管 (CVC) 功能障碍是住院儿童的常见并发症,通常是由于内血栓形成.
- 恢复CVC通透性对于重症儿科患者的治疗至关重要.
研究的目的:
- 调查使用血栓解毒剂治疗儿童心血管功能障碍的情况.
- 确定使用血栓溶解剂与在医院获得的静脉血栓塞栓症 (HA-VTE) 发生率之间的关联.
主要方法:
- 多中心回顾性队列研究,使用儿科健康信息系统数据库.
- 包括2023年患有CVC的重症儿童 (<18岁).
- 用多变量逻辑回归来比较CVC功能障碍中暴露和未暴露于血栓抑制剂 (alteplase,urokinase) 的儿童之间的HA-VTE率.
主要成果:
- 分析了超过9,800名儿童和10,900名CVC.
- 在33.8%的中心中,用于治疗心血管功能障碍的血栓溶解剂.
- 在医院获得的静脉血栓塞栓症 (HA-VTE) 发生在11.9%的病例中.
- 血栓解压剂的使用独立地与HA-VTE的风险增加有关 (aOR: 1.89; 95% CI: 1.64-2.19).
结论:
- 治疗心血管功能障碍的血栓溶解剂在重症儿童中很常见.
- 这种使用显着与患HA-VTE的风险增加有关.
- 可能需要进一步的研究来优化CVC管理,并最大限度地降低VTE风险.
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