在危急病患者中,贫血和输血
Jean Louis Vincent1, Jean-François Baron, Konrad Reinhart
1Department of Intensive Care, Erasme University Hospital, Route de Lennik 808, Brussels, 1070, Belgium. jlvincen@ulb.ac.be
JAMA
|September 24, 2002
概括
贫血常见于重症监护室 (ICU),许多患者接受红细胞 (RBC) 输血. 这项研究发现,输血与危急病患者的器官功能障碍和死亡率增加有关.
科学领域:
- 关键护理医学 关键护理医学
- 血液学 血液学 血液学
- 流行病学 流行病学
背景情况:
- 贫血常见于入住重症监护室 (ICU) 的重症患者中.
- 贫血对该患者群体的发病率和死亡率的影响尚不清楚.
- 在ICU中经常抽血会导致贫血.
研究的目的:
- 为了确定贫血和红细胞 (RBC) 输血率的发病率,在重症患者.
- 调查红细胞输血在ICU环境中的潜在益处和风险.
- 探索贫血,输血和患者结果之间的关联.
主要方法:
- 一项前性观察性研究涉及两个组成部分:血液采样研究和贫血和输血研究.
- 从145-146个西欧ICU收集的数据,包括超过1100名 (血液采样) 和3500名 (贫血/输血) 患者.
- 测量的主要结果包括抽血量,血红蛋白水平,输血率,器官功能障碍 (序列器官衰竭评估得分) 和28天或医院出院的死亡率.
主要成果:
- 每名患者每天抽取的平均血量显著,与器官功能障碍有积极的相关性.
- 近30%的ICU患者在入院时血红蛋白水平低于10g/dL.
- 观察到大量的输血率 (37%),老年患者和长时间住入ICU的患者的比率更高.
- 与未输血患者相比,接受输血的患者的ICU和整体死亡率显著更高.
- 即使对器官功能障碍严重程度进行调整后,输血患者的死亡率也增加了.
结论:
- 贫血是重症患者经常出现的疾病,导致大量使用红细胞 (RBC) 输血.
- 这项研究提供了流行病学证据,将红细胞输血与较差的结果联系起来,包括器官功能下降和死亡率增加.
- 这些发现表明需要重新评估重症监护机构的输血实践.
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