MỘT SỐ CHỈ SỐ ĐÔNG CẦM MÁU VÀ LIÊN QUAN TIÊN LƯỢNG Ở BỆNH NHÂN NGỘ ĐỘC NẶNG ĐƯỢC LỌC MÁU LIÊN TỤC SỬ DỤNG HEPARIN

Abstract

Objective: To describe some coagulation indicators and their correlation with clinical presentations in a group of patients with severe poisoning undergoing continuous hemodialysis using heparin at the Poison Control Center in Bach Mai Hospital. Subjects and Methods: 50 patients diagnosed with severe acute poisoning, treated with continuous hemodialysis methods (CVVHDF) for the first time to eliminate toxins, control hemodynamics, and balance fluids and electrolytes at the Poison Control Center in Bach Mai Hospital, from May 2023 to June 2024. Study Method: Cross-sectional. Results: The mean age was 53±16 years, ranging from 17 to 90 years. The most common clinical presentations included hypotension shock, with 92% of patients required vasopressors. 78% had underlying diseases (cirrhosis, cardiovascular disease, diabetes, etc.). Coagulation tests showed that most patients had normal APTT levels, 36% had a reduced prothrombin ratio, and 40% had a decreased platelet count. 14% of patients showed discordance between APTT and Anti-Xa results 6 hours after dialysis. 8 patients experienced coagulopathy, 50% of whom reached the heparin dose. Patients with a history of cirrhosis had 11.90 times higher risk of mortality compared to those without cirrhosis, with p=0.05.