体外器官支持(extracorporeal organ support,ECOS)对挽救危重症患者具有重大意义,但治疗过程中存在出血和血栓形成等相关不良事件,因此ECOS治疗中抗凝剂的选择十分重要.该文对肝素(heparin)、低分子肝素、直接凝血酶抑制剂以及枸橼酸(citric acid)在体外膜肺氧合(extracorporeal membrane oxygenation,ECMO)和连续性肾脏替代治疗(continuous renal replacement therapy,CRRT)中抗凝应用进行综述,阐释ECMO和CRRT中抗凝药物使用现状,归纳总结抗凝药物特点、禁忌证和相关不良反应,旨在为深入探究ECMO中肝素替代药物以及高出血风险患者CRRT抗凝药物选择提供一定理论基础.
Research progress in the use of anticoagulant drugs in extracorporeal organ support therapy
Extracorporeal organ support(ECOS)plays a crucial role in rescuing critically ill patients,however,there are adverse events such as bleeding and thrombosis during treatment,so selecting appropriate anticoagulants is very important in ECOS therapy.This article reviewed the anticoagulant application of heparin,low molecular weight heparin,direct thrombin inhibitors,and citric acid in extracorporeal membrane oxygenation(ECMO)and continuous renal replacement therapy(CRRT),elucidated the current usage status of anticoagulant drugs in ECMO and CRRT,summarized their characteristics,contraindications and associated adverse reactions,in order to provide certain theoretical basis for deeply exploring alternative options to heparin in ECMO and selecting appropriate anticoagulant drugs for high-risk bleeding patients undergoing CRRT.
extracorporeal membrane oxygenationcontinuous renal replacement therapyanticoagulant drug
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