Abstract:
UNASSIGNED: Unfractionated heparin is a widely used anticoagulant in critically ill patients. It has a well-established safety profile and remains an attractive option for clinicians due to its short half-life and reversibility. Heparin has a unique pharmacokinetic profile, which contributes to significant inter-patient and intra-patient variability in effect. The variability in anticoagulant effect combined with heparin\'s short half-life mean close monitoring is required for clinical efficacy and preventing adverse effects. To optimize heparin use in critically ill patients, effective monitoring assays and dose adjustment strategies are needed.
UNASSIGNED: This paper explores the use of heparin as an anticoagulant and optimal approaches to monitoring in critically ill patients.
UNASSIGNED: Conventional monitoring assays for heparin dosing have significant limitations. Emerging data appear to favor using anti-Xa assay monitoring for heparin anticoagulation, which many centers have successfully adopted as the standard. The anti-Xa assay appears have important benefits relative to the aPTT for heparin monitoring in critically ill patients, and should be considered for broader use.
摘要:
■普通肝素是危重患者中广泛使用的抗凝剂。它具有良好的安全性,并且由于其半衰期短和可逆性,仍然是临床医生的有吸引力的选择。肝素具有独特的药代动力学特征,这有助于显著的患者间和患者内差异的效果。抗凝作用的变异性与肝素的短半衰期平均联合需要密切监测临床疗效和预防不良反应。为了优化重症患者的肝素使用,需要有效的监测测定和剂量调整策略。
■本文探讨了在危重患者中使用肝素作为抗凝剂和最佳监测方法。
■用于肝素给药的常规监测测定具有显著的局限性。新出现的数据似乎有利于使用抗Xa测定监测肝素抗凝,许多中心已成功将其用作标准。在危重病人的肝素监测中,抗-Xa分析似乎相对于aPTT具有重要的益处。应该考虑更广泛的用途。