在急诊心肺转流期间阿哌沙班的细胞吸附血液灌流：一例报告。
Cytosorb hemoadsorption of apixaban during emergent cardio-pulmonary bypass: a case report.
机构信息
Department of Cardiac Surgery, Lausanne University Hospital, Lausanne, Switzerland.
Department of Anaesthesiology, Lausanne University Hospital, Lausanne, Switzerland.
出版信息
Perfusion. 2021 Nov;36(8):873-875. doi: 10.1177/0267659120967827. Epub 2020 Oct 26.
BACKGROUND
Peri-operative coagulation management of patients receiving apixaban, a new oral anticoagulant, is difficult. The CytoSorb hemoadsorption device might represent a therapeutic option to reduce apixaban's pharmacological and inflammatory effects during high-risk surgery.
CASE PRESENTATION
An 83-year-old woman treated with Apixaban underwent emergent redo mitral valve replacement for prosthetic valve endocarditis. A CytoSorb cartridge was added to the cardio-pulmonary bypass (CPB) circuit. Apixaban-specific anti-factor Xa activity (AFXaA) were measured peri-operatively. After 100 minutes of CPB, a 50% AFXaA rate decrease was observed as compared to pre-CPB values. Furthermore, we noticed 39% and 44% reductions of AFXaA levels in comparison to the expected levels in patients with normal or altered renal function, respectively.
CONCLUSION
Insertion of a CytoSorb cartridge in the CPB was safe and associated with rapid correction of Apixaban-associated anticoagulation.
背景
接受新型口服抗凝剂阿哌沙班的患者围手术期凝血管理较为困难。细胞吸附器可能是一种治疗选择，可以降低高危手术期间阿哌沙班的药理和炎症作用。
病例介绍
一位 83 岁女性因人工瓣膜心内膜炎接受紧急二尖瓣置换术。在体外循环（CPB）回路中添加了一个 CytoSorb 药盒。围手术期测量了阿哌沙班特异性抗因子 Xa 活性（AFXaA）。与 CPB 前相比，CPB 后 100 分钟时观察到 AFXaA 活性降低了 50%。此外，与肾功能正常或异常的患者的预期水平相比，AFXaA 水平分别降低了 39%和 44%。
结论
在 CPB 中插入 CytoSorb 药盒是安全的，并与阿哌沙班相关抗凝作用的快速纠正相关。
Zotero 插件