损失或稀释-一种新的诊断方法来评估稀释对标准实验室参数的影响
Nicole Innerhofer1, Sasa Rajsic1, Marco Ronzani1
1Department of Anesthesiology and Intensive Care Medicine, Medical University Innsbruck, 6020 Innsbruck, Austria.
Diagnostics (Basel, Switzerland)
|August 12, 2023
概括
在心脏手术期间的手术内流体治疗会导致血液稀释,显著降低血红蛋白,血小板数量和前列血时间. 本研究引入了一种评估稀释方法.
科学领域:
- 心血管外科心血管外科
- 麻醉学 麻醉学
- 输血医学 输血医学
背景情况:
- 术内流体治疗是心脏外科手术中使用心肺旁路 (CPB) 的标准.
- 液体的使用会导致血液稀释,这可能会影响用于输血决策的实验室参数.
- 血红蛋白 (Hgb),血小板计数 (PLT) 和前热血素时间 (PT) 是受血稀释影响的关键参数.
研究的目的:
- 评估手术内流体治疗诱导的血液稀释对Hgb,PLT和PT的影响.
- 评估一种新的稀释系数公式,用于量化流体治疗效果.
- 为了确定稀释效应是否影响血液产品替代指南.
主要方法:
- 对174名接受心脏手术的患者进行前性观察性研究.
- 使用纳德勒公式计算总血液体积.
- 测量静脉注射液体和减去尿液,以确定液体效应,并在CPB结束时应用稀释系数公式.
主要成果:
- 与基线相比,在CPB结束时,血液体积中位数增加了148%.
- 观察到明显的稀释依赖性下降:Hgb减少24%,PLT减少41%,PT减少44%.
- 观察到的稀释效应是显著的 (p < 0.001) 并独立于CPB持续时间.
结论:
- 在心脏手术患者中,手术内流体治疗显著稀释Hgb,PLT和PT.
- 基于计算的方法可以量化血液稀释,帮助解释实验室参数.
- 这种方法可以改善血液产品替代和输血值的指导.
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