回顾体外膜氧合支持中的抗凝注意事项。

IF 2.9 3区 医学 Q2 PHARMACOLOGY & PHARMACY
Pharmacotherapy Pub Date : 2023-12-01 Epub Date: 2023-08-14 DOI:10.1002/phar.2857
Sydney D T Graboyes, Phillip S Owen, Rickey A Evans, Theodore J Berei, Katarzyna M Hryniewicz, Ian B Hollis
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引用次数: 0

摘要

体外膜肺氧合(ECMO)自 1975 年首次获得成功以来,越来越多地用于肺和心肺旁路。自 21 世纪初以来,在成人中的应用呈指数级增长,但尽管国际上使用静脉-动脉(VA)和静脉-静脉(VV)ECMO 进行了数千次插管,但仍存在大量与血液相容性相关的不良事件。目前的抗凝管理以 2014 年发布的体外生命支持组织指南为基础,并于 2022 年发布了最新更新。尽管有了这一指南,但国际上对如何管理 ECMO 中的抗凝仍缺乏共识。为撰写这篇综述,我们对多个电子数据库进行了全面检索,以确定与使用 VV 或 VA-ECMO 的成人患者的抗凝相关的研究。我们最优先考虑前瞻性、随机对照研究,但在缺乏此类资源的情况下,我们也考虑纳入观察性研究、回顾性非对照研究和病例系列/报告。本文件旨在全面回顾目前对与 ECMO 相关的抗凝管理的理解。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Review of anticoagulation considerations in extracorporeal membrane oxygenation support.

Since its first success in 1975, extracorporeal membrane oxygenation (ECMO) has been used with increasing frequency for pulmonary and cardiopulmonary bypass. Use in adults has increased exponentially since the early 2000s, but despite thousands of international cannulations using both veno-arterial (VA) and veno-venous (VV) ECMO, there are still significant hemocompatibility-related adverse events. Current management of anticoagulation has been based on the Extracorporeal Life Support Organization guidance published in 2014 with recent updates published in 2022. Despite this guidance, there is still limited international consensus on how to manage anticoagulation in ECMO. For this review, we completed a comprehensive search of multiple electronic databases to identify studies pertaining to anticoagulation of adult patients on VV or VA-ECMO. The highest priority was given to sources that were prospective, randomized, controlled studies, but in the absence of such resources, observational studies, retrospective uncontrolled studies, and case series/reports were considered for inclusion. This document serves to provide a comprehensive review of the current understanding of management pertaining to anticoagulation relating to ECMO.

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来源期刊
Pharmacotherapy
Pharmacotherapy 医学-药学
CiteScore
7.80
自引率
2.40%
发文量
93
审稿时长
4-8 weeks
期刊介绍: Pharmacotherapy is devoted to publication of original research articles on all aspects of human pharmacology and review articles on drugs and drug therapy. The Editors and Editorial Board invite original research reports on pharmacokinetic, bioavailability, and drug interaction studies, clinical trials, investigations of specific pharmacological properties of drugs, and related topics.
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