体外膜肺氧合支持的成年患者的抗凝治疗：国际血栓与止血学会围手术期和重症监护止血与血栓形成科学与标准化委员会的指南。

Anticoagulation in adult patients supported with extracorporeal membrane oxygenation: guidance from the Scientific and Standardization Committees on Perioperative and Critical Care Haemostasis and Thrombosis of the International Society on Thrombosis and Haemostasis.

机构信息

Strasbourg University (UNISTRA), Strasbourg University Hospital, Medical Intensive Care Unit - NHC, INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine (RNM), FMTS, Strasbourg, France.

Sorbonne Université, UMRS 1166, AP-HP. Sorbonne Université, Pitié-Salpêtrière Hospital, Paris, France.

出版信息

J Thromb Haemost. 2023 Feb;21(2):373-396. doi: 10.1016/j.jtha.2022.11.014. Epub 2022 Dec 22.

DOI:10.1016/j.jtha.2022.11.014

PMID:36700496

Abstract

Anticoagulation of patients supported by extracorporeal membrane oxygenation is challenging because of a high risk of both bleeding and thrombotic complications, and often empirical. Practice in anticoagulation management is therefore highly variable. The scope of this guidance document is to provide clinicians with practical advice on the choice of an anticoagulant agent, dosing, and the optimal anticoagulant monitoring strategy during extracorporeal membrane oxygenation support in adult patients.

摘要

体外膜肺氧合支持的患者的抗凝治疗具有挑战性，因为出血和血栓并发症的风险都很高，而且往往是经验性的。因此，抗凝管理的实践具有很大的变异性。本指南文件的范围是为临床医生提供关于在成人患者接受体外膜肺氧合支持期间选择抗凝剂、剂量和最佳抗凝监测策略的实用建议。