New perspective of anticoagulation in intensive care unit:basic and clinical advances in coagulation factor Ⅻ and Ⅺ inhibitors
Anticoagulation therapy stands as a key treatment for thrombotic diseases.The consequential bleeding risk tied to existing anticoagulation methods significantly impacts patient prognosis.In the intensive care unit(ICU),patients often necessitate organ support,leading to the inevitable placement of artificial devices in blood vessels,thereby requiring anticoagulation treatment to avert clot formation that might impede organ support.Nevertheless,these patients commonly encounter a heightened risk of bleeding.Hemophilia B,identified in 1953,manifests as a deficiency in coagulation factorⅪ(FⅪ),which focused people's perspective on the endogenous coagulation pathway,that is,the contact pathway.Upon interaction between the surface of artificial devices and FⅫ,FⅫ activates,subsequently triggering FⅪand initiating the"coagulation cascade"within the contact pathway.Inhibitors targeting the contact pathway encompass two primary categories:FⅫ inhibitors and FⅪ inhibitors,capable of impeding this process.This article reviews the role of FⅫand FⅪin activating the contact pathway,seeking to illuminate their contributions to thrombus formation.By listing the relatively mature drugs and their indications,clinicians are familiar with this new anticoagulant.
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