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重症患者的预防性血小板输血反应:一个前性的多中心观察性研究
Florian Reizine1,2, Sarah Le Marec3, Anthony Le Meur4
1Maladies Infectieuses Et Réanimation Médicale, CHU de Rennes, Rennes, France.
Critical care (London, England)
|September 27, 2023
概括
危急病患者往往对预防性血小板输血反应不佳,近四分之三的患者经历了低于最佳的增量. 血小板存储时间是干预的关键因素.
科学领域:
- 关键护理医学 关键护理医学
- 血液学 血液学 血液学
- 输血医学 输血医学
背景情况:
- 预防性血小板输血在重症患者中很常见,但反应可能不一致.
- 优化输血实践对于改善患者结果至关重要.
研究的目的:
- 描述重症患者的预防性血小板输血反应.
- 识别与低于最佳反应相关的因素.
- 确定不良反应对临床结果的影响.
主要方法:
- 在重症监护室对472例预防性血小板输血进行了前性多中心观察性研究.
- 血输后18-24小时后,定义为校正计数增量 (CCI) < 7 的不良反应.
- 混合效应模型用于评估与不良反应相关的因素.
主要成果:
- 73.9%的输血和77.9%的患者显示血小板输血反应不佳.
- 与反应不良相关的因素包括血液恶性瘤,败血症,较高的SOFA得分和更长的血小板存储时间.
- 血红蛋白和BMI与更好的反应有关.
结论:
- 在重症患者的预防性输血后,低于最佳的血小板增加是常见的.
- 血小板存储时间是干预可获得的因素,与反应不佳有关.
- 根据输血反应,临床结果没有显著差异.
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