Correlation Among Antifactor Xa, Activated Partial Thromboplastin Time, and Heparin Dose and Association with Pediatric Extracorporeal Membrane Oxygenation Complications.
Correlation Among Antifactor Xa, Activated Partial Thromboplastin Time, and Heparin Dose and Association with Pediatric Extracorporeal Membrane Oxygenation Complications.
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DOI：
10.1097/mat.0000000000000986
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发表时间：
2020-03
期刊：
影响因子：
4.2
通讯作者：
Ozment, Caroline P.
中科院分区：
文献类型：
--
作者：
McMichael, Ali B. V.;Hornik, Christoph P.;Hupp, Susan R.;Gordon, Sharon E.;Ozment, Caroline P.
关键词：
在体外膜氧合(ECMO)过程中，抗凝是必不可少的，以防止灾难性的电路凝结。有几种方法可以监测普通肝素(UFH)，这是ECMO中最常用的抗凝剂，但没有一种测试或组合测试一直被证明是优越的。这项回顾性观察研究探讨了抗凝血因子Xa水平、活化部分凝血活酶时间(APTT)和普通肝素(UFH)剂量之间的相关性，以及抗凝血因子Xa水平和aPTT与存活率、出血和血栓并发症的关系。纳入从2012年9月至2014年12月在同一机构连续69名新生儿和儿童ECMO患者。采用Spearman等级相关分析比较抗Xa因子水平、aPTT和UFH剂量。抗凝血因子Xa水平与UFH剂量ρ=0.1p<；0.0001，aPTT与UFH剂量ρ=0.26p<；0.0001有显著相关性，但相关性较差。抗Xa因子水平与aPTT呈弱相关，ρ=0.38(p<；0.0001)。在单变量分析中，生存期与抗Xa因子水平、aPTT或UFH剂量之间没有差异。ECMO时多项抗凝试验可能优于单项抗凝试验。
Anticoagulation is essential during extracorporeal membrane oxygenation (ECMO) to prevent catastrophic circuit clotting. Several assays exist to monitor unfractionated heparin (UFH), the most commonly used anticoagulant during ECMO, but no single test or combination of tests has consistently been proven to be superior. This retrospective observational study examines the correlation between anti-factor Xa level, activated partial thromboplastin time (aPTT), and unfractionated heparin (UFH) dose and the association between anti-factor Xa level and aPTT with survival and hemorrhagic and thrombotic complications. Sixty-nine consecutive neonatal and pediatric ECMO patients from September 2012 to December 2014 at a single institution were included. Spearman rank correlation was used to compare anti-factor Xa level, aPTT, and UFH dose. Significant but poor correlation exists between anti-factor Xa level and UFH dose ρ= 0.1 (p < 0.0001) and aPTT and UFH dose ρ = 0.26 (p < 0.0001). Anti-factor Xa level and aPTT were weakly correlated to each other ρ = 0.38 (p < 0.0001). In an univariate analysis, there was no difference between survival and anti-factor Xa level, aPTT, or UFH dose. Multiple anticoagulation tests may be superior to a single test during ECMO.