XIII因子缩剂 缓解儿科外体膜出血 氧化支持 获得的XIII因子缺乏症
Jun Fujita1, Ashish A Ankola2, Arun Saini2
1From the Department of Pathology & Immunology, Baylor College of Medicine, Houston, Texas.
概括
向身体外膜氧化 (ECMO) 的儿科患者给予XIII因子 (FXIII) 缩剂,改善了出血严重程度. 低于50%的FXIII水平表明需要使用FXIII来控制ECMO期间的出血.
科学领域:
- 儿科重症监护医药 儿科重症监护医药
- 血液学 血液学 血液学
- 进行心血管外科手术.
背景情况:
- 在需要体外膜氧化 (ECMO) 的患者中,出血是显著的并发症.
- 获得的XIII因子 (FXIII) 缺乏通常在ECMO期间发生,但其对出血结果的影响和FXIII的疗效仍然未得到充分研究.
研究的目的:
- 评估XIII因子 (FXIII) 度对经受ECMO治疗的儿科患者出血并发症的影响.
- 确定潜在的FXIII值水平,以指导治疗决策.
主要方法:
- 对接受FXIII缩剂输液的儿科ECMO患者进行了回顾性审查.
- 血液严重程度是使用国际血栓与血液静止学会 (ISTH) 的出血定义进行分类的.
- 分析了FXIII管理前和后的XIII因子水平和出血分数.
主要成果:
- 20名患者接受了27次FXIII输液,剂量为37±8单位/公斤.
- 输液后的FXIII水平显著增加,从41%增加到68% (p < 0.001).
- 平均ISTH出血分数显著下降,从2.0降至0.8 (p < 0.001),表明出血严重程度有所改善.
结论:
- 在儿科ECMO患者中,XIII因子缩剂的使用与改善出血严重程度有关,特别是当初始FXIII水平低于50%时.
- 对于患有持续出血的儿科ECMO患者,建议测量FXIII水平并考虑FXIII的使用,特别是低于50%的水平.
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