UASSIGNED:关于比伐卢定与肝素在体外膜氧合中的抗凝治疗存在争议。我们本研究的目的是评估比伐卢定与肝素在成人静脉-静脉体外膜氧合(V-VECMO)期间维持全身抗凝的有效性和安全性。
UNASSIGNED:回顾性招募2018年2月至2022年2月在我们中心接受V-VECMO支持的成年患者。我们分析了他们的ECMO支持时间,血小板计数,凝血指标,血液制品输注量,血栓形成和出血的发生率,ECMO成功断奶的概率,和住院死亡率。
未经授权:共有58名患者接受了V-VECMO支持。根据排除和纳入标准,最终纳入34例患者,14和20接受比伐卢定和肝素抗凝治疗,分别。血小板最低值(98.50×109/L(85.50,123.75)vs49.50×109/L(31.25,83.00),p=0.002)和平均血小板值(149.90×109/L(127.40,164.80)vs74.55×109/L(62.45,131.60),p=0.03)和ECMO成功断奶的比率(92.8%vs60.0%,p=0.033)比伐卢定组明显高于肝素组。红细胞输注量(7.00U(3.00,13.25)vs13.75U(7.25,22.63),p=0.039),血小板输注量(0.00mL(0.00,75.00)vs300mL(0.00,825.00),p=0.027),和大出血的发生率(0.00%vs30%,p=0.024)比伐卢定组明显低于肝素组。
未经证实:在V-VECMO支持的成年患者中,比伐卢定的全身抗凝治疗达到了与肝素相同的抗凝治疗目标,且大出血事件的发生频率较低,对血液制品的需求较低,但血栓形成风险没有显著增加.对于V-VECMO支持的成年患者,比伐卢定很可能是一种安全有效的抗凝方法。
UNASSIGNED: There were controversial opinions on the use of
bivalirudin versus heparin for anticoagulant therapy in extracorporeal membrane oxygenation. The aim of our present study is to evaluate the efficacy and safety of
bivalirudin versus heparin for the maintenance of systemic anticoagulation during adult veno-venous extracorporeal membrane oxygenation (V-V ECMO).
UNASSIGNED: Adult patients who received V-V ECMO support in our center between February 2018and February 2022 were retrospectively recruited. We analyzed their ECMO support time, platelet count, coagulation indicators, blood product infusion volume, the incidence of thrombosis and bleeding, probability of successful weaning of ECMO, and in-hospital mortality.
UNASSIGNED: A total of 58 patients received V-V ECMO support. Thirty-four patients were finally included according to the exclusion and inclusion criteria, 14 and 20 accepted
bivalirudin and heparin for anticoagulant therapy, respectively. The Minimum platelet value (98.50 × 109/L (85.50, 123.75) vs 49.50 × 109/L (31.25, 83.00), p = 0.002) and mean platelet value (149.90 × 109/L (127.40, 164.80) vs 74.55 × 109/L (62.45, 131.60), p = 0.03) and the ratio of successful weaning of ECMO (92.8% vs 60.0%, p = 0.033) in bivalirudin group were significantly higher than those in heparin group. The red blood cell infusion volume (7.00 U (3.00, 13.25) vs 13.75 U (7.25, 22.63), p = 0.039), platelet infusion volume (0.00 mL (0.00, 75.00) vs 300 mL (0.00, 825.00), p = 0.027), and the incidence of major bleeding (0.00% vs 30%, p = 0.024) in bivalirudin group were significantly lower than those in heparin group.
UNASSIGNED: In V-V ECMO-supported adult patients, systemic anticoagulation with
bivalirudin has achieved the same anticoagulation targets as heparin with less frequency of major bleeding events and lower requirement for blood products without significantly increased risk of thrombosis.
Bivalirudin most likely is a safe and effective anticoagulation method for adult patients supported by V-V ECMO.