心脏手术后氨甲环酸对血液透析患者的长期作用:1例报告。

IF 0.5

A&A Practice Pub Date : 2023-05-01 DOI:10.1213/XAA.0000000000001676

Ryogo Yoshii, Yuya Takahashi, Teiji Sawa, Fumimasa Amaya, Satoru Ogawa

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引用次数: 1

摘要

一位患有慢性肾功能不全的61岁妇女计划接受主动脉瓣置换术。在注射1g氨甲环酸(TXA)后，ClotPro系统的TPA(组织纤溶酶原激活剂)测试结果显示纤维蛋白溶解有广泛的抑制作用。术后6 h血TXA水平由71 μg/dL降至25 μg/dL;然而，没有观察到进一步的下降。虽然术后第1天血液透析后TXA水平降至6.9 μg/dL，但直到第2天，tpa测试的纤溶关闭仍保持不变。在透析患者中，低剂量的TXA

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Long Duration of Action of Tranexamic Acid After Cardiac Surgery in a Hemodialysis Patient: A Case Report.

A 61-year-old woman with chronic renal dysfunction was scheduled to undergo aortic valve replacement. After a bolus of 1 g tranexamic acid (TXA), the TPA (tissue-plasminogen activator)-test result with the ClotPro system demonstrated extensive inhibition of fibrinolysis. Plasma TXA level decreased from 71 to 25 μg/dL at 6 hours postoperatively; however, no further decrease was observed. Although TXA levels dropped to 6.9 μg/dL after hemodialysis on postoperative day (PoD) 1, fibrinolytic shutdown on the TPA-test remained unchanged until PoD 2. In dialysis patients, low-dose TXA <1 g may be considered for reducing seizure and thromboembolic complications after cardiac surgery.

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来源期刊

A&A Practice ANESTHESIOLOGY-

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期刊介绍： A & A Case Reports, our new online journal publishing Case Reports, related Editorial Commentary, and Correspondence. Anesthesia & Analgesia 1 and Anesthesiology 2 recently announced that they were suspending publication of Case Reports. One reason is that Case Reports typically reduce the Impact Factor of a journal because they are rarely cited. Regardless of the merits of Impact Factor as a metric of journal worth, journals and their editors necessarily consider Impact Factor in strategic planning. At the same time, Case Reports are appreciated by readers for describing “real life” management of difficult or unusual cases not often encountered by practitioners. In a recent issue of Anesthesia & Analgesia, Steven Shafer1 identified many Case Reports whose publication launched productive careers dedicated to solving the puzzle posed by an unusual observation in a single patient.