Yao Ruishan, Huang Haiyan, Ming Yaohui, Guo Huiling, Miao Lingli, Wang Su, Wan Jia, Zhou Jin, Wang Xiaofang, Wu Yanli, Yuan Yaowen, Wang Ting, Li Ruiting
Department of Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Front Med (Lausanne). 2025 Jun 18;12:1568333. doi: 10.3389/fmed.2025.1568333. eCollection 2025.
Therapeutic plasma exchange (TPE) is widely used in various fields of clinical practice. There are two main modes of TPE: centrifugal TPE (cTPE) and membrane TPE (mTPE). No matter which mode of TPE, anticoagulant therapy is essential to prevent clotting in the extracorporeal circuit. Therefore, selecting a suitable and safe anticoagulant is crucial. Currently, heparin and citrate are the most commonly used anticoagulants. Different anticoagulant regimens have varying advantages, disadvantages, and associated complications, making them suitable for different TPE modes. This review aims to summarize relevant research findings to provide clinicians with evidence to guide their selection of appropriate anticoagulants during TPE.
治疗性血浆置换(TPE)在临床实践的各个领域中广泛应用。TPE主要有两种模式:离心式TPE(cTPE)和膜式TPE(mTPE)。无论采用哪种TPE模式,抗凝治疗对于防止体外循环凝血至关重要。因此,选择合适且安全的抗凝剂至关重要。目前,肝素和枸橼酸盐是最常用的抗凝剂。不同的抗凝方案具有不同的优缺点及相关并发症,使其适用于不同的TPE模式。本综述旨在总结相关研究结果,为临床医生在TPE期间选择合适的抗凝剂提供指导依据。