切换至 "中华医学电子期刊资源库"

第五届中国出版政府奖音像电子网络出版物奖提名奖

中国科技核心期刊

中国科学引文数据库(CSCD)来源期刊

中华重症医学电子杂志 ›› 2020, Vol. 06 ›› Issue (02) : 156 -159. doi: 10.3877/cma.j.issn.2096-1537.2020.02.010

所属专题: 重症医学 文献

专题笔谈

体外膜氧合中肝素相关性血小板减少症的处理
许华1, 王勇强1,()   
  1. 1. 300192 天津市第一中心医院重症医学科
  • 收稿日期:2019-12-10 出版日期:2020-05-28
  • 通信作者: 王勇强

Management of heparin-associated thrombocytopenia in extracorporeal membrane oxygenation

Hua Xu1, Yongqiang Wang1,()   

  1. 1. Department of Critical Care Medicine, Tianjin First Center Hospital, Tianjin 300192, China
  • Received:2019-12-10 Published:2020-05-28
  • Corresponding author: Yongqiang Wang
  • About author:
    Corresponding author: Wang Yongqiang, Email:
引用本文:

许华, 王勇强. 体外膜氧合中肝素相关性血小板减少症的处理[J/OL]. 中华重症医学电子杂志, 2020, 06(02): 156-159.

Hua Xu, Yongqiang Wang. Management of heparin-associated thrombocytopenia in extracorporeal membrane oxygenation[J/OL]. Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition), 2020, 06(02): 156-159.

肝素诱导的血小板减少症(HIT)是一种临床应用肝素过程中出现最多的非出血性免疫相关的并发症,在体外膜氧合(ECMO)使用过程中发生的概率不高,但致命性极强。因此ECMO使用过程中预防HIT极其重要。此外,掌握HIT发生时的处理策略并在该并发症发生早期给予正确的干预是降低ECMO并发HIT患者死亡的关键。本文旨在对ECMO中HIT的处理作简要分析。

Heparin induced thrombocytopenia (HIT) is a non-hemorrhagic immune-related complication that occurs most frequently in the clinical application of heparin. The probability of occurrence of HIT is not high during the use of extracorporeal membrane oxygenation (ECMO), but it is extremely lethal. Therefore, it is extremely important to prevent the occurrence of HIT during the use of ECMO. In addition, being familiar with the treatment strategy for HIT and giving proper intervention early when this complication occurs are the keys to reducing the mortality of patients. This article briefly analyzes the management of heparin-related thrombocytopenia in extracorporeal membrane oxygenation.

1
Arepally GM. Heparin-induced thrombocytopenia[J]. Blood, 2017, 129(21): 2864-2872.
2
Joseph J, Rabbolini D, Enjeti AK, et al. Diagnosis and management of heparin-induced thrombocytopenia: a consensus statement from the Thrombosis and Haemostasis Society of Australia and New Zealand HIT Writing Group[J]. Med J Aust, 2019, 210(11): 509-516.
3
Cuker A, Arepally GM, Chong BH, et al. American Society of Hematology 2018 guidelines for management of venous thromboembolism: heparin-induced thrombocytopenia[J]. Blood Adv, 2018, 2(22): 3360-3392.
4
中国医师协会心血管内科医师分会血栓防治专业委员会《中华医学杂志》编辑委员会. 肝素诱导的血小板减少症中国专家共识(2017)[J]. 中华医学杂志, 2018, 98(6): 408-417.
5
Cavarocchi NC. Introduction to Extracorporeal Membrane Oxygenation[J]. Crit Care Clin, 2017, 33(4): 763-766.
6
Hill JD, O′Brien TG, Murray JJ, et al. Prolonged extracorporeal oxygenation for acute post-traumatic respiratory failure (shock-lung syndrome). Use of the Bramson membrane lung[J]. N Engl J Med, 1972, 286(12): 629-634.
7
Davies A, Jones D, Bailey M, et al. Extracorporeal Membrane Oxygenation for 2009 Influenza A(H1N1) Acute Respiratory Distress Syndrome[J]. JAMA, 2009, 302(17): 1888-1895.
8
Pham T, Combes A, Rozé H, et al. Extracorporealmembrane oxygenation for pandemic influenza A (H1N1)-induced acute respiratory distress syndrome: a cohort study and propensity-matched analysis[J]. Am J Respir Crit Care Med, 2013, 187: 276-85.
9
Cavarocchi NC. Introduction to Extracorporeal Membrane Oxygenation[J]. Crit Care Clin, 2017, 33(4): 763-766.
10
黑飞龙,龙村. 体外膜肺氧合并发症防治进展[J]. 中国体外循环杂志, 2007, 5(4): 250-252.
11
Pollak U. Heparin-induced thrombocytopenia complicating extracorporeal membrane oxygenation support: Review of the literature and alternative anticoagulants[J]. J Thromb Haemost, 2019, 17(10): 1608-1622.
12
Pollak U. Heparin-induced thrombocytopenia complicating extracorporeal membrane oxygenation support in pediatric patients: review of the literature and alternative anticoagulants[J]. Perfusion, 2018, 33(1_suppl): 7-17.
13
Cuker A, Arepally G, Crowther MA, et al. The HIT Expert Probability (HEP) Score: a novel pre-test probability model for heparin-induced thrombocytopenia based on broad expert opinion[J]. J Thromb Haemost, 2010, 8(12): 2642-2650.
14
Younis M, Ya′qoub L, Ali Z, et al. Comparison of a clinical-laboratory algorithm, 4t and heparin-induced thrombocytopenia expert probability scores in the diagnosis of heparin-induced thrombocytopenia in the critical care setting[J]. Am J Blood Res, 2019, 9(3): 25-33.
15
Li S, Fan LK, Wang SJ, et al. Prospective evaluation of heparin-induced thrombocytopenia expert probability and 4T scores in Chinese patients with suspected heparin-induced thrombocytopenia[J]. Chin Med J (Engl), 2019, 132(12): 1441-1447.
16
Vayne C, Guery EA, Kizlik-Masson C, et al. Beneficial effect of exogenous platelet factor 4 for detecting pathogenic heparin- induced thrombocytopenia antibodies[J]. Br J Haematol, 2017, 179(5): 811-819.
17
Pandya KA, Johnson EG, Davis GA, et al. Serotonin release assay (SRA)-negative HIT: a newly recognized entity: implications for diagnosis and management[J]. Thromb Res, 2018, 172: 169-171
18
Warkentin TE, Nazy I, Sheppard JI, et al. Serotonin-release assay-negative heparin-induced thrombocytopenia[J]. Am J Hematol, 2020, 95(1): 38-47.
19
Fathi M. Heparin-induced thrombocytopenia (HIT): Identification and treatment Pathways[J]. Glob Cardiol Sci Pract, 2018, 2018(2): 15.
20
宋景春,刘树元,朱峰, 等. 中国成人重症患者血小板减少诊疗专家共识[J]. 解放军医学杂志, 2020, 45(2): 95-112.
21
Rougé A, Pelen F, Durand M, et al. Argatroban for an alternative anticoagulant in HIT during ECMO[J]. J Intensive Care, 2017, 5: 39.
22
Sin JH, Lopez ND. Argatroban for Heparin-Induced Thrombocytopenia during Venovenous Extracorporeal Membrane Oxygenation with Continuous Venovenous Hemofiltration[J]. J Extra Corpor Technol, 2017, 49(2): 115-120.
23
Phillips MR, Khoury AI, Ashton RF, et al. The dosing and monitoring of argatroban for heparin-induced thrombocytopenia during extracorporeal membrane oxygenation: a word of caution[J]. Anaesth Intensive Care, 2014, 42(1): 97-98.
24
Koster A, Niedermeyer J, Gummert J, et al. Low dose bivalirudin anticoagulation for lung transplantation with extracorporeal membrane oxygenation in a patient with acute heparin-induced thrombocytopenia[J]. Eur J Cardiothorac Surg, 2017, 51(5): 1009-1011.
25
Netley J, Roy J, Greenlee J, et al. Bivalirudin Anticoagulation Dosing Protocol for Extracorporeal Membrane Oxygenation: A Retrospective Review[J]. J Extra Corpor Technol, 2018, 50(3): 161-166.
26
Pieri M, Agracheva N, Bonaveglio E, et al. Bivalirudin versus heparin as an anticoagulant during extracorporeal membrane oxygenation: a case-control study[J]. J Cardiothorac Vasc Anesth, 2013, 27(1): 30-34.
27
Berei TJ, Lillyblad MP, Wilson KJ, et al. Evaluation of Systemic Heparin Versus Bivalirudin in Adult Patients Supported by Extracorporeal Membrane Oxygenation[J]. ASAIO J, 2018, 64(5): 623-629.
28
Macielak S, Burcham P, Whitson B, et al. Impact of anticoagulation strategy and agents on extracorporeal membrane oxygenation therapy[J]. Perfusion, 2019, 34(8): 671-678.
29
Netley J, Roy J, Greenlee J, et al. Bivalirudin Anticoagulation Dosing Protocol for Extracorporeal Membrane Oxygenation: A Retrospective Review[J]. J Extra Corpor Technol, 2018, 50(3): 161-166.
30
Parlar AI, Sayar U, Cevirme D, et al. Successful use of fondaparinux in a patient with heparin-induced thrombocytopenia while on extracorporeal membrane oxygenation after mitral valve redo surgery[J]. Int J Artif Organs, 2014, 37(4): 344-347.
31
Bauer C, Vichova Z, Ffrench P, et al. Extracorporeal membrane oxygenation with danaparoid sodium after massive pulmonary embolism[J]. Anesth Analg, 2008, 106(4): 1101-1103,
32
Dager WE, Gosselin RC, Yoshikawa R, et al. Lepirudin in heparin-induced thrombocytopenia and extracorporeal membranous oxygenation[J]. Ann Pharmacother, 2004, 38(4): 598-601.
33
Balasubramanian SK, Tiruvoipati R, Chatterjee S, et al. Extracorporeal membrane oxygenation with lepirudin anticoagulation for Wegener′s granulomatosis with heparin-induced thrombocytopenia[J]. ASAIO J, 2005, 51(4): 477-479.
[1] 谢江燕, 王亚菲, 贺芳. 妊娠合并血栓性血小板减少性紫癜2例并文献复习[J/OL]. 中华妇幼临床医学杂志(电子版), 2024, 20(05): 556-563.
[2] 王刘欣, 郭艳霞, 陈永进, 张旻, 李强. 激光治疗应用于撕脱性损伤牙再植根面处理的研究进展[J/OL]. 中华口腔医学研究杂志(电子版), 2024, 18(05): 345-350.
[3] 刘柏隆, 周祥福. 女性尿失禁吊带手术并发症处理的经验分享[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2025, 19(01): 127-127.
[4] 江志鹏, 钟克力, 陈双. 复杂腹壁疝手术后腹腔高压与腹腔间室综合征的预防和处理[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(06): 612-615.
[5] 王学虎, 赵渝. 复杂腹壁疝手术中血管损伤并发症的预防和处理[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(06): 616-619.
[6] 林凯, 潘勇, 赵高平, 杨春. 造口还纳术后切口疝的危险因素分析与预防策略[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(06): 634-638.
[7] 赖乾德, 吕相琴, 蔺洋, 刘媛梅, 赵春艳, 李琦. 肝素结合蛋白对慢性阻塞性肺疾病预后预测分析[J/OL]. 中华肺部疾病杂志(电子版), 2024, 17(04): 613-616.
[8] 李干斌, 侯睿, 郭雅萍, 张潇, 邱小原, 牛备战, 林国乐. 改良经辅助切口回肠造口在腹腔镜直肠癌根治术的应用[J/OL]. 中华腔镜外科杂志(电子版), 2024, 17(05): 271-276.
[9] 王向丽, 吴涛, 毛东锋, 刘恒, 刘文慧, 周芮, 田红娟. 异基因造血干细胞移植治疗ANKRD26相关性血小板减少症1例并文献复习[J/OL]. 中华细胞与干细胞杂志(电子版), 2024, 14(04): 236-238.
[10] 周迪, 全志伟. 规范化胆囊良性疾病诊治流程减少胆囊癌误诊误治[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 749-753.
[11] 张龙, 孙善柯, 徐伟, 李文柱, 李俊达, 池涌泉, 何广胜, 成峰, 王学浩, 饶建华. 腹腔镜脾切除治疗血液系统疾病的临床疗效分析[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 870-875.
[12] 周璐, 温镕博, 刘子璇, 李奕飏, 周乐其, 朱晓明, 龚海峰, 高显华, 楼征, 刘连杰, 郝立强, 于冠宇, 张卫. Changhai-AL-Prediction预测模型指导预防性造口合理实施的卫生经济学研究[J/OL]. 中华结直肠疾病电子杂志, 2024, 13(04): 280-287.
[13] 李佳曦, 刘子源, 李学民. 二甲双胍对年龄相关性白内障影响的研究进展[J/OL]. 中华眼科医学杂志(电子版), 2024, 14(04): 252-256.
[14] 陈芳, 王建英, 曹建用, 刘丽, 罗晓琴. 基于分析-设计-开发-实施-评价模式的叙事护理培训在产科预防性介入治疗中的应用[J/OL]. 中华介入放射学电子杂志, 2024, 12(04): 392-396.
[15] 李兰兰, 龚忆华, 陈泳欣, 郑纯翠, 易石坚. 失效模式和效果分析模式提高医院保洁人员标准预防依从性的效果[J/OL]. 中华卫生应急电子杂志, 2024, 10(05): 277-280.
阅读次数
全文


摘要


AI


AI小编
你好!我是《中华医学电子期刊资源库》AI小编,有什么可以帮您的吗?