摘要
儿童脓毒症、血液系统/肿瘤疾病和外伤大手术等经常合并严重的出凝血功能障碍。这类患儿体外膜肺氧合(ECMO)时的抗凝管理难度大,容易发生出血或栓塞等并发症,是导致死亡的主要因素。如何平衡抗凝与出血/血栓等并发症是ECMO管理的重要环节。本文对儿童危重症ECMO治疗期间的凝血改变,如何优化抗凝药物和抗凝监测方法等进行介绍。
Sepsis,leukemia/cancer and severe trauma/surgery always contribute to severe coagulation dysfunction in children.The anticoagulation management during extracorporeal membrane pulmonary oxygenation(ECMO)is quite difficult because of complications such as bleeding or embolism and received more attention.How to dynamically balance anticoagulation with bleeding and thrombosis is crucial in ECMO support.This review summarized advances on prevention and management of coagulation disorder,and the optimizing of monitoring coagulation during ECMO.
作者
史婧奕
张育才
Shi Jingyi;Zhang Yucai(Department of Critical Care Medicine,Shanghai Children′s Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200062,China)
出处
《中国小儿急救医学》
CAS
2023年第10期726-730,共5页
Chinese Pediatric Emergency Medicine
基金
上海市科委"科技创新行动计划"医学创新研究专项项目(20Y11901300)。
关键词
体外膜肺氧合
凝血障碍
抗凝
危重症
儿童
Extracorporeal membrane oxygenation
Coagulation disorders
Anti-coagulation
Critical illness
Children
