获得性因子 XIII 缺乏在体外膜肺氧合治疗期间很常见，且与严重出血事件和输血需求相关。
Acquired Factor XIII Deficiency Is Common during ECMO Therapy and Associated with Major Bleeding Events and Transfusion Requirements.
作者信息
Noitz Matthias, Brooks Roxane, Szasz Johannes, Jenner Dennis, Böck Carl, Krenner Niklas, Dünser Martin W, Meier Jens
机构信息
Department of Anesthesiology and Intensive Care Medicine, Kepler University Hospital GmbH, Johannes Kepler University Linz, Krankenhausstraße 9, 4020 Linz and Altenberger Strasse 69, 4040 Linz, Austria.
Institute of Signal Processing, Johannes Kepler University Linz, Altenberger Strasse 69, 4040 Linz, Austria.
出版信息
J Clin Med. 2023 Jun 18;12(12):4115. doi: 10.3390/jcm12124115.
BACKGROUND
Bleeding events are frequent complications during extracorporeal membrane oxygenation therapy (ECMO).
OBJECTIVE
To determine the rate of acquired factor XIII deficiency and its association with major bleeding events and transfusion requirements in adults undergoing ECMO therapy.
MATERIALS AND METHODS
A retrospective single centre cohort study. Adult patients receiving veno-venous or veno-arterial ECMO therapy during a 2-year period were analysed and screened for factor XIII activity measurements. Factor XIII deficiency was defined based on the lowest factor XIII activity measured during ECMO therapy.
RESULTS
Among 84 subjects included into the analysis, factor XIII deficiency occurred in 69% during ECMO therapy. There were more major bleeding events (OR, 3.37; 95% CI, 1.16-10.56; = 0.02) and higher transfusion requirements (red blood cells, 20 vs. 12, < 0.001; platelets, 4 vs. 2, = 0.006) in patients with factor XIII deficiency compared to patients with normal factor XIII activity. In a multivariate regression model, factor XIII deficiency was independently associated with bleeding severity ( = 0.03).
CONCLUSIONS
In this retrospective single centre study, acquired factor XIII deficiency was observed in 69% of adult ECMO patients with a high bleeding risk. Factor XIII deficiency was associated with higher rates of major bleeding events and transfusion requirements.
背景
出血事件是体外膜肺氧合治疗（ECMO）期间常见的并发症。
目的
确定获得性因子 XIII 缺乏症的发生率及其与接受 ECMO 治疗的成人主要出血事件和输血需求的关联。
材料与方法
一项回顾性单中心队列研究。分析并筛选了在两年期间接受静脉 - 静脉或静脉 - 动脉 ECMO 治疗的成年患者的因子 XIII 活性测量值。因子 XIII 缺乏症根据 ECMO 治疗期间测得的最低因子 XIII 活性来定义。
结果
在纳入分析的 84 名受试者中，69% 在 ECMO 治疗期间出现因子 XIII 缺乏症。与因子 XIII 活性正常的患者相比，因子 XIII 缺乏症患者发生更多的主要出血事件（比值比，3.37；95% 置信区间，1.16 - 10.56；P = 0.02）且输血需求更高（红细胞，20 单位对 12 单位，P < 0.001；血小板，4 单位对 2 单位，P = 0.006）。在多变量回归模型中，因子 XIII 缺乏症与出血严重程度独立相关（P = 0.03）。
结论
在这项回顾性单中心研究中，69% 的成年 ECMO 患者存在获得性因子 XIII 缺乏症，且出血风险高。因子 XIII 缺乏症与更高的主要出血事件发生率和输血需求相关。
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