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与输血相关的急性肺损伤:临床综述
Alexander P J Vlaar1, Nicole P Juffermans
1Department of Intensive Care Medicine, Academic Medical Centre, Amsterdam, Netherlands.
Lancet (London, England)
|May 7, 2013
概括
与输血相关的急性肺损伤 (TRALI) 是输血死亡的主要原因. 像排除某些女性捐赠者和识别患者风险因素等策略正在减少TRALI发病率.
科学领域:
- 输血医学 输血医学
- 免疫学 免疫学 免疫学
- 临界护理医学 临界护理医学
背景情况:
- 输血相关的急性肺损伤 (TRALI) 曾经很少见,但现在是输血相关死亡的主要原因.
- 了解TRALI的发病因子,从血液银行的角度来看,已经导致了预防策略.
研究的目的:
- 审查TRALI理解和管理的演变.
- 突出关键的预防策略和新出现的患者特异性风险因素.
主要方法:
- 对输血医学文献和监管认可的审查.
- 对TRALI发病率和死亡率的流行病学数据的分析.
- 确定供体排除和患者风险分层策略.
主要成果:
- 除了高血量产品的女性捐赠者,TRALI发病率降低了大约三分之二.
- 尽管采取了预防措施,但TRALI仍然是一个重大的临床问题.
- 已经确定了TRALI患者相关的风险因素,从而实现了个性化输血方法.
结论:
- 通过供体查和风险因素识别,TRALI预防已取得显著进展.
- 对患者特异性因素的进一步研究对于彻底消除TRALI至关重要.
- 对输血管理的个性化方法对于患者安全至关重要.
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