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Association of Activated Clotting Time-Guided Anticoagulation with Complications during Extracorporeal Membrane Oxygenation Support: A Systematic Review and Meta-Analysis.活化凝血时间指导抗凝与体外膜肺氧合支持期间并发症的相关性:系统评价和荟萃分析。
J Cardiothorac Vasc Anesth. 2024 Dec;38(12):3034-3042. doi: 10.1053/j.jvca.2024.09.003. Epub 2024 Sep 7.
2
Anticoagulation Monitoring Using Activated Clotting Time in Patients Receiving Extracorporeal Membrane Oxygenation: A Meta-Analysis of Correlation Coefficients.使用活化凝血时间监测接受体外膜肺氧合治疗的患者的抗凝治疗:相关性系数的荟萃分析。
J Cardiothorac Vasc Anesth. 2024 Nov;38(11):2651-2660. doi: 10.1053/j.jvca.2024.07.048. Epub 2024 Aug 5.
3
Anti-Xa-guided Anticoagulation With Unfractionated Heparin and Thrombosis During Extracorporeal Membrane Oxygenation Support: A Systematic Review and Meta-analysis.抗 Xa 指导下的普通肝素抗凝与体外膜肺氧合支持期间的血栓形成:系统评价和荟萃分析。
J Cardiothorac Vasc Anesth. 2024 Aug;38(8):1662-1672. doi: 10.1053/j.jvca.2024.03.042. Epub 2024 Apr 2.
4
Association of anti-factor Xa-guided anticoagulation with hemorrhage during ECMO support: A systematic review and meta-analysis.抗 Xa 因子指导的抗凝治疗与 ECMO 支持期间出血的关系:系统评价和荟萃分析。
Clin Cardiol. 2024 May;47(5):e24273. doi: 10.1002/clc.24273.
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aPTT-guided anticoagulation monitoring during ECMO support: A systematic review and meta-analysis.在 ECMO 支持期间,以 aPTT 指导的抗凝监测:系统评价和荟萃分析。
J Crit Care. 2023 Oct;77:154332. doi: 10.1016/j.jcrc.2023.154332. Epub 2023 May 25.
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J Clin Med. 2022 Aug 31;11(17):5147. doi: 10.3390/jcm11175147.
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2021 ELSO Adult and Pediatric Anticoagulation Guidelines.2021 年 ELSO 成人和儿科抗凝指南。
ASAIO J. 2022 Mar 1;68(3):303-310. doi: 10.1097/MAT.0000000000001652.
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Anticoagulation Management and Antithrombin Supplementation Practice during Veno-venous Extracorporeal Membrane Oxygenation: A Worldwide Survey.在静脉-静脉体外膜肺氧合期间的抗凝管理和抗凝血酶补充实践:一项全球调查。
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体外膜肺氧合支持期间的抗凝监测:监测还是抛硬币决定?

Anticoagulation Monitoring During ECMO Support: Monitor or Flip a Coin?

作者信息

Rajsic Sasa, Treml Benedikt

机构信息

Department of Anaesthesiology and Intensive Care Medicine, Medical University Innsbruck, Innsbruck, Austria.

出版信息

Clin Cardiol. 2024 Dec;47(12):e70061. doi: 10.1002/clc.70061.

DOI:10.1002/clc.70061
PMID:39692163
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11653157/
Abstract

Should we rely on anticoagulation monitoring in ECMO patients or simply flip a coin? The increasing use of anti-factor Xa activity to monitor the effect of UFH appears appropriate, given its moderate correlation with the UFH infusion rates, and it may play a role in preventing thromboembolic events. However, to avoid bleeding complications, more sophisticated tools, and careful clinical decision-making remain essential.

摘要

我们应该依靠对体外膜肺氧合(ECMO)患者进行抗凝监测,还是干脆抛硬币决定?鉴于抗Xa因子活性与普通肝素(UFH)输注速率具有中等相关性,越来越多地使用抗Xa因子活性来监测UFH的效果似乎是合适的,并且它可能在预防血栓栓塞事件中发挥作用。然而,为避免出血并发症,更精密的工具以及谨慎的临床决策仍然至关重要。