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成人体外膜肺氧合中的抗凝剂:替代标准化抗凝治疗的普通肝素。

Anticoagulants in adult extracorporeal membrane oxygenation: alternatives to standardized anticoagulation with unfractionated heparin.

机构信息

Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

Institute of Clinical Pharmacology, Zhengzhou University, Zhengzhou, China.

出版信息

Eur J Clin Pharmacol. 2023 Dec;79(12):1583-1594. doi: 10.1007/s00228-023-03568-3. Epub 2023 Sep 23.

Abstract

BACKGROUND

Extracorporeal membrane oxygenation (ECMO) is a vital technique for severe respiratory or heart failure patients. Bleeding and thrombotic events are common during ECMO and negatively impact patient outcomes. Unfractionated heparin is the primary anticoagulant, but its adverse effects limit its use, necessitating alternative anticoagulants.

OBJECTIVE

Review available alternative anticoagulants for adult ECMO patients. Explore potential novel anticoagulants for future ECMO use. Aim to reduce complications (bleeding and thrombosis) and improve safety and efficacy for critically ill ECMO patients.

METHODS

Comprehensive literature review of existing and emerging anticoagulants for ECMO.

RESULTS

Identified a range of alternative anticoagulants beyond unfractionated heparin. Evaluated their potential utility in mitigating ECMO-related complications.

CONCLUSION

Diverse anticoagulant options are available and under investigation for ECMO. These alternatives may enhance patient safety and outcomes during ECMO support. Further research and clinical studies are warranted to determine their effectiveness and safety profiles.

摘要

背景

体外膜肺氧合(ECMO)是严重呼吸或心力衰竭患者的重要治疗技术。在 ECMO 过程中,出血和血栓形成事件很常见,会对患者的预后产生负面影响。未分级肝素是主要的抗凝剂,但由于其不良反应限制了其使用,需要替代抗凝剂。

目的

回顾成人 ECMO 患者可用的替代抗凝剂。探讨未来 ECMO 应用的潜在新型抗凝剂。旨在减少并发症(出血和血栓形成),提高危重症 ECMO 患者的安全性和疗效。

方法

对 ECMO 中现有的和新兴的抗凝剂进行全面的文献回顾。

结果

确定了除未分级肝素以外的一系列替代抗凝剂。评估了它们在减轻 ECMO 相关并发症方面的潜在效用。

结论

有多种抗凝剂可供选择,并正在研究用于 ECMO。这些替代品可能会提高 ECMO 支持期间患者的安全性和预后。需要进一步的研究和临床研究来确定它们的有效性和安全性。

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