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Thiago M Oliveira¹, Michael E Billington¹, Raghu R Seethala¹

¹Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA.

Journal of clinical medicine

|October 28, 2023

概括

与其他患者相比,患有神经疾病的重症患者接受了更少的限制性输血协议. 在美国的重症监护病房中,在两组人群中,大规模输血协议也被类似地使用.

科学领域:

关键护理医学关键护理医学
神经学神经学
输血医学输血医学

背景情况:

了解重症患者输血方案的变化对于优化护理至关重要.
与没有神经损伤的患者相比,神经受伤的患者可能有不同的输血需求.
现有的关于在重症监护室 (ICU) 中基于初级诊断的协议利用的数据有限.

研究的目的:

调查ICU中限制性输血协议 (RTP) 和大规模输血协议 (MTP) 的流行情况.
为了比较中枢神经系统 (CNS) 诊断和非中枢神经系统诊断的患者的协议利用和血液产品的使用.
确定初级诊断是否影响使用的输血协议类型或接受血液制品的可能性.

主要方法:

展望性,观察性,多中心队列研究,涉及69个美国ICU.
对USCIITG-CIOS的子组分析,招募了6179名患者.
与其他患者相比,对1266名初级中枢神经系统诊断的患者进行评估,评估在前24小时内使用协议和服用血液产品.

主要成果:

与非中枢神经系统患者 (42.9%) 相比,在护理中枢神经系统患者 (36.9%) 的ICU中使用限制性输血协议 (RTP) 的频率较低.
大规模输血协议 (MTP) 在中枢神经系统 (48.3%) 和非中枢神经系统 (47.4%) 患者之间显示出相似的利用率.
中枢神经系统诊断的患者在24小时内获得的红细胞 (4.3%对14.6%),新鲜冷血 (2.9%对5.1%) 和体产品 (3.2%对9.2%) 显著减少.

结论:

在美国ICU中神经和非神经受伤患者之间使用限制性输血协议存在显著差异.
大规模输血协议同样适用于不管初始诊断.
神经受伤的患者在ICU治疗的最初24小时内接受的血液制品和体较少.

关键词:

血液制品输血输血输血输血关键护理关键护理的关键护理神经系统疾病神经系统疾病协议协议协议协议

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