集中 治療 室 で の 赤 血球 輸血
Senta Jorinde Raasveld1, Sanne de Bruin1, Merijn C Reuland1
1Department of Intensive Care, Amsterdam University Medical Centers, Amsterdam, the Netherlands.
JAMA
|October 12, 2023
まとめ
赤血球 (RBC) 輸血は,世界的に集中治療室 (ICU) で一般的です. 赤血球輸血の慣行とヘモグロビン基準は,世界中の様々なICUで大きく異なります.
科学分野:
- クリティカル ケア 医療
- 血液学
- クリニック・プラクティス
背景:
- 赤血球 (RBC) 輸血は,集中治療室 (ICU) で頻繁に行われる治療である.
- 臨床試験で確立されたヘモグロビン (Hb) 値にもかかわらず,ICUでの赤血球輸血の現在の臨床慣行は,世界的にほとんど特徴づけられていない.
研究 の 目的:
- 集中治療室での赤血球輸血の国際的慣行を調査し,描写する.
- 異なる国際環境における赤血球輸血プロトコルと結果の変動性を評価する.
主な方法:
- 30カ国の233のICUで3643人の成人患者を対象とした国際的な前向きなコホート研究です.
- 定義された期間 (2019年3月〜2022年10月) にわたって収集されたデータは,赤血球輸血の発生,徴候,Hbレベル,ICU滞在中に輸血された単位に焦点を当てています.
主要な成果:
- 患者の25%が赤血球輸血を受けたが,中心部,国,大陸によって有意な差異があった.
- 低ヘモグロビン (Hb) レベル (平均7. 4g/ dL),活発な出血,および血液動力学的不安定性は,輸血の主な指示でした.
- 輸血の慣行は幅広く変化しており,ICUの輸血患者の約84%はHb濃度の中央値が7g/ dL以上であった.
結論:
- 赤血球輸血は 世界的にICUでよく行われています
- ICUの間で赤血球輸血の慣行には,国際的に大きな違いがある.
- これらの様々な実践が患者の治療結果に与える影響を理解するためにさらなる研究が必要である.
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