空气医疗输血作为大规模输血协议触发器的输血
Brian Cornelius1, Dennis Thompson2, Phillip Kilgore3
1Graduate Program in Nurse Anesthesia, Texas Wesleyan University, Fort Worth, TX; Department of Anesthesia, John Peter Smith Hospital, Fort Worth, TX; Department of Anesthesia, Ochsner LSU Health, Shreveport, LA.
Air medical journal
|September 16, 2023
概括
提供输血的空中医疗服务无法可靠地触发大规模输血协议. 然而,直升机紧急医疗服务 (HEMS) 护理减少了输血量,并在抵达时改善了患者的血液动力学.
科学领域:
- 紧急医疗 紧急医疗
- 创伤外科 手术 创伤外科
- 控制出血 控制出血
背景情况:
- 空中医疗服务提高了在受伤点获得血液制品的机会.
- 早期激活大规模输血协议 (MTP) 可以显著改善创伤患者的生存率.
- 确定早期MTP激活的可靠标准仍然是一个挑战.
研究的目的:
- 调查血液制品的空气医疗管理是否是大规模输血激活的风险因素.
- 评估医院前生命体征的有用性,以计算创伤患者的冲击指数.
- 评估直升机紧急医疗服务 (HEMS) 对输血量和患者结果的影响.
主要方法:
- 追溯性研究,将HEMS输血的成人创伤患者与机构MTP患者进行比较.
- 对HEMS输血作为MTP激活的触发器的分析.
- 评估医院前的生命体征,以计算冲击指数和评估血液消耗得分.
主要成果:
- 没有发现HEMS输血是MTP激活的可靠触发器,可能是由于样本大小的限制.
- 在到达创伤中心时,HEMS护理与输血量减少和血液动力学参数的改善有关.
- 在HEMS患者中,更高的特兰胺酸剂量可能有助于改善结局.
结论:
- 仅仅是空中医疗输血并不是早期激活大规模输血协议的充分标准.
- 包括输血和胺酸在内的HEMS干预措施似乎可以改善早期创伤患者的稳定性.
- 冲击指数和血液消耗得分在这个HEMS群体中显示出有限的特异性.
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