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创伤患者的指导输血与旋转血栓收缩仪:一个单中心队列研究
Mina Salehi1, Rajan Bola2, Nenke de Jong2
1Division of General Surgery, Trauma and Acute Care Surgery, Vancouver General Hospital, University of British Columbia, Jim Pattison Pavilion, 855 W 12th Ave, Vancouver, BC, V5Z 1M9, Canada. mina.salehi@vch.ca.
World journal of emergency surgery : WJES
|July 1, 2023
概括
旋转性血小板造影仪 (ROTEM) 引导输血增加了创伤患者的纤维素原使用,但没有影响死亡率. 进一步的研究应该优化ROTEM的使用,以防止过度使用血液制品.
科学领域:
- 创伤护理 创伤护理
- 管理出血 管理出血
- 输血医学 输血医学
背景情况:
- 旋转性血栓形成显微镜 (ROTEM) 测量血液凝块的强度,以指导输血治疗.
- 对于创伤患者来说,ROTEM提供了实时血液静止数据.
- 目标导向输血旨在满足特定的静血需求.
研究的目的:
- 评估ROTEM指导输血对血液制品使用的影响.
- 评估ROTEM对创伤患者住院死亡率的影响.
主要方法:
- 单中心观察队列分析,比较前ROTEM和ROTEM期创伤患者.
- 为了进行比较,激活了大量出血协议.
- ROTEM于2016年11月实施,用于实时输血决策.
主要成果:
- 纤维素缩剂的使用在ROTEM组显著更高 (0.8对0.2单位,p=0.006).
- 输血的红细胞,血小板,冷沉积物或FFP没有显著差异.
- 住院死亡率没有显著差异 (33%与19%,p=0.22).
结论:
- 通过ROTEM引导的输血增加了纤维激素的使用,但没有改变死亡率.
- 没有观察到其他血液产品的改变.
- 未来的研究应该集中在ROTEM合规性和优化其使用,以防止过度使用.
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