在成年人中输血的概念
Lawrence T Goodnough1, Jerrold H Levy, Michael F Murphy
1Department of Pathology, Stanford University, Stanford, CA, USA. ltgoodno@stanford.edu
Lancet (London, England)
|May 28, 2013
概括
最好的输血实践正在改善,但结果各不相同,特别是在心胸外科手术中. 限制性输血方法越来越多地被采用为最佳实践,尽管正在进行的指导方针辩论.
科学领域:
- 输血医学 输血医学
- 临床实践指南 临床实践指南
- 患者的治疗结果.
背景情况:
- 基于证据的临床试验和指导方针已经推进了输血实践.
- 输血结果的变化仍然存在,特别是在心胸外科手术患者中.
- 导致变化的因素包括指导方针的理解,不同的建议,以及血红蛋白值的实用性.
研究的目的:
- 审查最佳输血实践的进展情况.
- 确定输血结果持续变化的原因.
- 为了突出越来越多地采用限制性输血方法.
主要方法:
- 基于证据的临床试验的分析.
- 发表的临床实践指南的审查.
- 检查血液使用和患者结果的流程改进.
主要成果:
- 在确定和实施最佳输血实践方面取得了重大进展.
- 输血结果的实质性变化仍然存在于特定的临床环境中,如心胸外科手术.
- 限制性输血方法越来越多地被作为最佳实践实施,得到机构经验和国家数据的支持.
结论:
- 尽管取得了进展,但输血结果的变化需要进一步研究和指导方针的澄清.
- 了解和解决血红蛋白值和证据有效性的细微差别至关重要.
- 限制性输血策略的趋势代表了向优化血液利用和患者护理的方向迈进.
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