多粘菌素B血液灌流期间的局部枸橼酸盐-钙抗凝：病例系列
Regional citrate-calcium anticoagulation during polymyxin-B hemoperfusion: A case series.
作者信息
Forfori Francesco, Brogi Etrusca, Sidoti Anna, Giraudini Martina, Monti Gianpaola, Zarrillo Nadia, Cantaluppi Vincenzo, Ronco Claudio
机构信息
1 Department of Anesthesia and Intensive Care, University of Pisa, Pisa, Italy.
2 Department of Anesthesiology and Intensive Care, Azienda Ospedaliera Niguarda Cà Granda, Milano, Italy.
出版信息
Int J Artif Organs. 2018 Jun;41(6):319-324. doi: 10.1177/0391398818762360. Epub 2018 Mar 26.
INTRODUCTION
So far, only heparin-based anticoagulation has been proposed during polymyxin-B hemoperfusion. However, postsurgical septic patients can be at high risk of bleeding due to either surgical complications or septic coagulation derangement. Consequently, heparin should not represent in some cases the anticoagulation regimen of choice in this type of patients.
METHODS AND RESULTS
We present a case series of four postsurgical septic patients treated with polymyxin-B hemoperfusion using regional citrate anticoagulation. All the treatments were performed without complications. During each treatment, there were no episodes of filter clotting, no bleeding, and no metabolic complications for any of the patients.
CONCLUSION
To our knowledge, this is the second published report on the use of citrate anticoagulation during polymyxin-B hemoperfusion. Our case series continued to show that regional citrate anticoagulation regimen is feasible and safe during polymyxin-B hemoperfusion treatment in postsurgical septic patients.
引言
到目前为止，在多粘菌素B血液灌流期间仅推荐使用基于肝素的抗凝方法。然而，术后脓毒症患者可能因手术并发症或脓毒症凝血紊乱而有较高的出血风险。因此，在某些情况下，肝素不应作为这类患者的抗凝治疗方案。
方法与结果
我们展示了一组4例术后脓毒症患者的病例系列，这些患者接受了使用局部枸橼酸盐抗凝的多粘菌素B血液灌流治疗。所有治疗均未出现并发症。在每次治疗期间，所有患者均未出现滤器凝血、出血及代谢并发症。
结论
据我们所知，这是关于在多粘菌素B血液灌流期间使用枸橼酸盐抗凝的第二篇发表报告。我们的病例系列继续表明，局部枸橼酸盐抗凝方案在术后脓毒症患者的多粘菌素B血液灌流治疗中是可行且安全的。
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