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输血酸盐对大规模输血中的病理生理学的影响
Jacob B Schriner1, J Michael Van Gent2, M Adam Meledeo3
1Center for Translational Injury Research, Department of Surgery, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, TX.
大量输血期间酸盐的积累可以通过损害凝血和降低水平而加剧出血. 在创伤患者中,管理酸盐负载至关重要,以防止凝血病和低血症的致命循环.
科学领域:
- 生理学 生理学 生理学
- 输血医学 输血医学
- 生物化学 生物化学
背景情况:
- 在出血的患者中,大量输血涉及大量的含酸盐的血液制品.
- 酸盐是一种用于储存血液中的抗凝剂,但它可以产生生理效应.
- 除了低血症之外,酸盐对患者结局的影响还需要进一步阐明.
研究的目的:
- 审查在流血患者大规模输血期间酸盐的生理影响.
- 探索酸盐,凝血病和创伤中的代谢障碍之间的复杂相互作用.
主要方法:
- 一个叙事审查的策划文学.
- 搜索包括"酸盐中毒"",酸盐大量输血"和"创伤性低热血症"等术语.
- 包括英语评论文章,前性和后性研究.
主要成果:
- 由于酸性和低温,在出血性休克中,酸盐清除受损.
- 循环中的酸盐抑制了血栓生成和血小板功能,加剧了凝血病.
- 酸盐有助于电离性低血症,在出血患者中产生有害的循环.
结论:
- 酸盐的生理影响超出了低血症,人们对其了解甚少.
- 与组件治疗相比,全血输血可能会减少酸盐负担.
- 限制酸盐输液和解决诱导的低血症对于治疗出血患者至关重要.
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