臨床実務における赤血球輸血
Harvey G Klein1, Donat R Spahn, Jeffrey L Carson
1Department of Transfusion Medicine, National Institutes of Health, Bethesda, Maryland 20892, USA. hklein@mail.cc.nih.gov
Lancet (London, England)
|August 7, 2007
まとめ
赤血球 (RBC) 輸血は酸素供給の回復に不可欠ですが,トリガーは不明です. 研究は,輸血の必要性に対するよりよい測定法を開発し,貯蔵病変の影響を理解することを目的としています.
科学分野:
- 血液学 ヘマトロジ
- 輸血医学とは
- 生理学 生理学とは
背景:
- 赤血球 (RBC) 輸血は,組織酸素供給が不十分である場合に重要な治療法である.
- 現在の輸血トリガーは,繊細な実験室検査が不足しているため,臨床判断に大きく依存しています.
- 輸血の有効性に対する赤血球貯蔵損傷の影響は十分に理解されていません.
研究 の 目的:
- 赤血球輸血における現在の理解と課題をレビューする.
- 輸血の必要性を判断するための改善された方法の必要性を強調する.
- RBCの貯蔵損傷と安全性に関する懸念の影響を議論する.
主な方法:
- 赤血球輸血の実践,貯蔵病変,および安全性に関する文献レビュー.
- 組織低酸素症の現在の診断上の限界の分析.
- 病原体不活性化技術と輸血合併症の検討.
主要な成果:
- RBC輸血は不可欠ですが,トリガーは論争の的であり,しばしば臨床経験に基づいています.
- 既存の実験室検査は,地域の組織低酸素を検出するための感度,再現性,および使いやすさが欠けている.
- 赤血球貯蔵病変の臨床的意義は,まだ十分に理解されていない.
- 感染症のリスクは,特に開発途上国において,病原体不活性化技術がまだ開発中であるため,依然として存在しています.
- 合併症にもかかわらず,赤血球輸血は好ましい治療指数を提供します.
結論:
- 赤血球輸血の決定を導くために,客観的な検査方法が不可欠である.
- 輸血結果を最適化するために,赤血球貯蔵病変に関するさらなる研究が必要である.
- 病原体不活性化による血液の安全性の向上は,特に資源の限られた環境では極めて重要です.
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