在VA-ECMO患者中,ABO血型和出血以及生存率
Gina H Sun1, Jamel P Ortoleva2, Shu Y Lu1
1Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA.
Journal of intensive care medicine
|June 9, 2023
概括
ABO血型影响体外膜氧化 (ECMO) 患者的输血需求. 虽然没有统计学意义,但O组患者需要更少的血液制品,AB组患者需要更多的血液制品,特别是冷沉剂.
科学领域:
- 心血管医学 心血管医学
- 血液学 血液学 血液学
背景情况:
- ABO血型显著影响血勃朗因子 (vWF) 水平.
- 组O与较低的vWF和较高的出血风险有关,而组AB具有较高的vWF和较高的血栓事件风险.
研究的目的:
- 在接受VA-ECMO的患者中调查 ABO 血型和输血需求之间的关联.
- 探索血液型,输血需求和ECMO患者的生存结果之间的关系.
主要方法:
- 对307名VA-ECMO患者的回顾性分析.
- 收集关于血液组分布,红细胞,新鲜冷血,血小板和冷沉积物使用的数据.
- 对30天和1年死亡率的分析.
主要成果:
- 组O患者 (40%) 对血液制品的需求最低,组AB患者 (6%) 对血液制品的需求最高,尽管对所有类型来说都不具有统计意义.
- 与O组相比,A,B和AB组的冷沉剂使用量明显高于O组 (P < .05).
- 增加的ECMO持续时间与更高的血液制品使用相关 (2-12%的增加每20%的日数增加).
结论:
- 在VA-ECMO患者中,ABO血型可能会影响输血需求,非O组的需求趋向于更高.
- 虽然死亡率差异在统计学上并不显著,但AB组的死亡率最低.
- 需要进一步的研究来阐明 ABO 血型,vWF 和 ECMO 患者的结果之间的复杂相互作用.
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