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[Mechanism and clinical treatment strategy of heparin resistance].
Men, J L; Xu, F Y; Zhai, Z G.
  • Men JL; Precision Medicine Center, Tianjin Medical University General Hospital, Tianjin 300052, China.
  • Xu FY; China-Japan Friendship Clinical Medical College, Capital Medical University, Beijing 100069, China.
  • Zhai ZG; Center of Respiratory Medicine, China-Japan Friendship Hospital; National Clinical Research Center for Respiratory Diseases; Department of Pulmonary and Critical Care Medicine, Beijing 100029, China.
Zhonghua Yi Xue Za Zhi ; 103(0): 707-713, 2023 Jan 10.
Article in Chinese | MEDLINE | ID: covidwho-2271849
ABSTRACT
Heparin resistance is becoming a hot issue of clinical concern. In critically ill patients, heparin resistance can lead to failure of anticoagulation therapy or increase the risk of major bleeding. Prompt recognition of heparin resistance can help to precisely adjust heparin dosage and avoid deterioration and adverse events. Heparin resistance can be mechanistically classified into the antithrombin-mediated and the non-antithrombin-mediated. Common etiologies include heparin-induced thrombocytopenia, severe infections such as severe COVID-19, treatment with extracorporeal circulation or extracorporeal membrane oxygenation (ECMO), and use of factor Xa reversal agents; heparin resistance is now often identified by the concordance of activated partial thromboplastin time (APTT) ratio with anti-FXa. Common clinical management strategies include antithrombin supplementation and replacement of anticoagulant drugs (e.g., direct thrombin inhibitors), but their safety and efficacy still need to be further validated.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Heparin / COVID-19 Type of study: Etiology study / Observational study / Prognostic study Limits: Humans Language: Chinese Journal: Zhonghua Yi Xue Za Zhi Year: 2023 Document Type: Article Affiliation country: Cma.j.cn112137-20220830-01838

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Heparin / COVID-19 Type of study: Etiology study / Observational study / Prognostic study Limits: Humans Language: Chinese Journal: Zhonghua Yi Xue Za Zhi Year: 2023 Document Type: Article Affiliation country: Cma.j.cn112137-20220830-01838