重症监护病房中肾脏替代治疗期间的肝素诱导的血小板减少症。
Heparin-induced thrombocytopenia during renal replacement therapy in the intensive care unit.
作者信息
Davenport Andrew
机构信息
Royal Free and University College Medical School, UCL Centre for Nephrology, Hampstead Campus, Rowland Hill Street, London NW3 2PF, UK.
出版信息
Crit Care. 2008;12(3):158. doi: 10.1186/cc6914. Epub 2008 Jun 30.
Abstract
Whereas some 30% to 50% of patients admitted to the intensive care unit develop thrombocytopenia during their stay, the incidence of heparin-induced thrombocytopenia (HIT) remains low, at around 0.3% to 0.5%. Lasocki and colleagues prospectively tested patients with premature clotting of the hemofiltration circuit for HIT, and reported a 25% incidence of HIT, particularly if the circuit clotted within 6 hours. By switching the anticoagulant from heparin to danaparoid, the hemofiltration circuit survival and urea clearances improved. HIT should therefore be clinically suspected if extracorporeal circuits clot repeatedly.
摘要
尽管入住重症监护病房的患者中约有30%至50%在住院期间会出现血小板减少症，但肝素诱导的血小板减少症（HIT）的发生率仍然较低，约为0.3%至0.5%。Lasocki及其同事对血液滤过回路过早凝血的患者进行了HIT的前瞻性检测，并报告HIT的发生率为25%，特别是如果回路在6小时内发生凝血。通过将抗凝剂从肝素改为达那肝素，血液滤过回路的存活率和尿素清除率得到了改善。因此，如果体外回路反复凝血，临床上应怀疑HIT。
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