PDF(Pubmed)
Abstract：
UNASSIGNED: In this study, we present our experience in treating patients receiving extracorporeal membrane oxygenation for novel coronavirus disease-2019 (COVID-19)-associated acute respiratory distress syndrome using a combined anticoagulant and antiaggregant treatment with intravenous infusion of bivalirudin and aspirin.
UNASSIGNED: Between April 1st, 2020 and January 31st, 2022, a total of 52 adult patients (32 males, 20 females; mean age: 44.5±11.5 years; range, 21 to 71 years) who received extracorporeal membrane oxygenation due to COVID-19-associated acute respiratory distress syndrome and whose anticoagulant treatment consisted of bivalirudin plus aspirin were retrospectively analyzed. During the first 10 days of extracorporeal membrane oxygenation, bivalirudin dosing, activated partial thromboplastin time, and activated clotting time, as well as major bleeding events and patient and/or ECMO-circuit thromboses were recorded.
UNASSIGNED: The mean bivalirudin dose per day ranged from 0.03 to 0.04 mg/kg/h, with a mean overall dose of 0.036 mg/kg/h. The mean activated partial thromboplastin time was 49.1±6.9 sec throughout 10 days of the application. The percentage of time in the target range for activated partial thromboplastin time was 58.9±20.1% within 10 days of application, compared to 33.1±31.1% for the first 24 h. The mean daily activated clotting time was below the target range within the first three days, but it was consistently within the target range after Day 3. During the first 10 days of the application, no mortality occurred. Major bleeding occurred in 11 patients (21.1%) and circuit thrombosis occurred in three patients (5.8%).
UNASSIGNED: In patients receiving extracorporeal membrane oxygenation for COVID-19-associated acute respiratory distress syndrome, an hourly bivalirudin dose of 0.03 to 0.04 mg/kg/h throughout the first 10 days of application was associated with the targeted anticoagulation profile of 45 to 60 sec. The combination was associated with a comparable rate of major bleeding, but a lower rate of circuit-thrombosis compared to the literature reports.
UNASSIGNED: Between April 1st, 2020 and January 31st, 2022, a total of 52 adult patients (32 males, 20 females; mean age: 44.5±11.5 years; range, 21 to 71 years) who received extracorporeal membrane oxygenation due to COVID-19-associated acute respiratory distress syndrome and whose anticoagulant treatment consisted of bivalirudin plus aspirin were retrospectively analyzed. During the first 10 days of extracorporeal membrane oxygenation, bivalirudin dosing, activated partial thromboplastin time, and activated clotting time, as well as major bleeding events and patient and/or ECMO-circuit thromboses were recorded.
UNASSIGNED: The mean bivalirudin dose per day ranged from 0.03 to 0.04 mg/kg/h, with a mean overall dose of 0.036 mg/kg/h. The mean activated partial thromboplastin time was 49.1±6.9 sec throughout 10 days of the application. The percentage of time in the target range for activated partial thromboplastin time was 58.9±20.1% within 10 days of application, compared to 33.1±31.1% for the first 24 h. The mean daily activated clotting time was below the target range within the first three days, but it was consistently within the target range after Day 3. During the first 10 days of the application, no mortality occurred. Major bleeding occurred in 11 patients (21.1%) and circuit thrombosis occurred in three patients (5.8%).
UNASSIGNED: In patients receiving extracorporeal membrane oxygenation for COVID-19-associated acute respiratory distress syndrome, an hourly bivalirudin dose of 0.03 to 0.04 mg/kg/h throughout the first 10 days of application was associated with the targeted anticoagulation profile of 45 to 60 sec. The combination was associated with a comparable rate of major bleeding, but a lower rate of circuit-thrombosis compared to the literature reports.
摘要：
■在这项研究中，我们介绍了我们在接受体外膜氧合治疗的新型冠状病毒病-2019(COVID-19)相关急性呼吸窘迫综合征患者中,使用联合抗凝和抗凝治疗,静脉输注比伐卢定和阿司匹林的经验.
■4月1日之间,2020年1月31日,2022年，共有52名成年患者（32名男性，20名女性；平均年龄：44.5±11.5岁；范围，回顾性分析21至71岁）因COVID-19相关急性呼吸窘迫综合征而接受体外膜氧合治疗的患者，其抗凝治疗包括比伐卢定和阿司匹林。在体外膜氧合的前10天，比伐卢定剂量,活化部分凝血活酶时间，和激活的凝血时间，以及主要出血事件和患者和/或ECMO回路血栓形成。
■每天平均比伐卢定剂量范围为0.03至0.04mg/kg/h，平均总剂量为0.036mg/kg/h。在整个施用的10天期间,平均活化部分凝血活酶时间为49.1±6.9秒。应用10天内活化部分凝血活酶时间在目标范围内的时间百分比为58.9±20.1%，与前24小时的33.1±31.1％相比。在前三天内，平均每日激活凝血时间低于目标范围，但在第3天之后，它始终在目标范围内。在申请的前10天，没有死亡发生。11例（21.1％）发生大出血，3例（5.8％）发生回路血栓形成。
■在接受体外膜氧合治疗COVID-19相关急性呼吸窘迫综合征的患者中，在应用的前10天,每小时剂量为0.03~0.04mg/kg/h的比伐卢定与45~60秒的目标抗凝方案相关.该组合与相当的大出血率相关，但与文献报道相比，回路血栓形成的发生率较低。
■4月1日之间,2020年1月31日,2022年，共有52名成年患者（32名男性，20名女性；平均年龄：44.5±11.5岁；范围，回顾性分析21至71岁）因COVID-19相关急性呼吸窘迫综合征而接受体外膜氧合治疗的患者，其抗凝治疗包括比伐卢定和阿司匹林。在体外膜氧合的前10天，比伐卢定剂量,活化部分凝血活酶时间，和激活的凝血时间，以及主要出血事件和患者和/或ECMO回路血栓形成。
■每天平均比伐卢定剂量范围为0.03至0.04mg/kg/h，平均总剂量为0.036mg/kg/h。在整个施用的10天期间,平均活化部分凝血活酶时间为49.1±6.9秒。应用10天内活化部分凝血活酶时间在目标范围内的时间百分比为58.9±20.1%，与前24小时的33.1±31.1％相比。在前三天内，平均每日激活凝血时间低于目标范围，但在第3天之后，它始终在目标范围内。在申请的前10天，没有死亡发生。11例（21.1％）发生大出血，3例（5.8％）发生回路血栓形成。
■在接受体外膜氧合治疗COVID-19相关急性呼吸窘迫综合征的患者中，在应用的前10天,每小时剂量为0.03~0.04mg/kg/h的比伐卢定与45~60秒的目标抗凝方案相关.该组合与相当的大出血率相关，但与文献报道相比，回路血栓形成的发生率较低。
