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输血增加了皮肤血流量,当最初的体积低时,在没有急性出血的复苏患者中增加了皮肤血流量

Elaine Cavalcante Dos Santos¹, Péter Bakos¹, Diego Orbegozo¹

¹Department of Intensive Care Medecine, Erasme University Hospital, Université Libre de Bruxelles (ULB), Brussels, Belgium.

Frontiers in medicine

|October 20, 2023

概括

红细胞输血 (RBCT) 在重症患者中没有显著改变整体皮肤血流. 然而,较低的基线皮肤血流 (SBF) 预测了对RBCT的积极反应,表明改善了组织输液.

科学领域:

关键护理医学关键护理医学
血液动力学血液动力学
组织 perfusion perfusion 组织 perfusion 组织 perfusion 组织 perfusion 组织 perfusion 组织 perfusion 组织 perfusion 组织 perfusion

背景情况:

皮肤血流 (SBF) 变化表明在重症患者的复苏后组织 perfusion 不足.
在这种情况下,红细胞输血 (RBCT) 对皮肤 perfusion 的影响仍然不够描述.

研究的目的:

评估RBCT对危急病患者皮肤组织输液的影响,在初始复苏后没有急性出血.

主要方法:

一项前性观察性研究,包括175名没有出血的成年患者,在液体复苏后接受RBCT.
激光多普勒被用来测量手指皮肤血液流动在基底温度 (SBF) 之前和RBCT后1小时.
关键的血液动力学和氧化参数 (MAP,HR,Hb,CVP,乳酸,SVO2) 被监测.

主要成果:

总体而言,SBF_BT在RBCT后没有显著变化 (p=0.67).
44%的患者 (SBF响应者) 在RBCT后SBF_BT增加了≥20%.
与非响应者相比,SBF响应者具有较低的基线SBF_BT,较低的混合静脉氧和和较低的CVP.
基线SBF_BT与输血后SBF_BT的增加独立相关,值为73.0PU,显示71.4%的灵敏度和70.4%的特异性.

结论:

在初始复苏后,RBCT在非出血,重症患者的皮肤血液流动中没有全球变化.
较低的基线SBF_BT是该患者群体中RBCT后改善皮肤组织输液的预测指标.

关键词:

贫血贫血是一种疾病.没有出血的危急患者.红细胞输血输血红细胞输血这是一种血症.皮肤血液流动血液流动皮肤激光多普勒仪组织 perfusion perfusion 组织 perfusion 组织 perfusion 组织 perfusion 组织 perfusion 组织 perfusion 组织 perfusion 组织 perfusion 组织 perfusion

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