身体外膜氧化 患者在遵循限制性输血协议后的结果
Jacob A Braaten1, Bridget S Dillon1, Jillian K Wothe1
1University of Minnesota Medical School, Minneapolis, MN.
Critical care explorations
|December 18, 2023
概括
一个严格的血液制品协议并没有降低患者在体外膜氧化 (ECMO) 的生存率. 这种方法安全地降低了血红蛋白水平,表明它有可能用于临床使用.
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
- 心血管外科心血管外科
背景情况:
- 身体外膜氧化 (ECMO) 需要仔细管理血液产品的利用.
- 以前的输血策略可能导致过度使用血液制品.
研究的目的:
- 评估限制性血液产品输血协议对ECMO患者结果的影响.
- 评估协议实施后血液产品利用和临床结果的变化.
主要方法:
- 在明尼苏达州医学中心的M Health Fairview大学对507名成年ECMO患者 (2019年1月至2021年12月) 的回顾性审查.
- 在2020年3月实施限制性协议 (血红蛋白<7,血小板<50,纤维素<100).
- 按ECMO类型分析子组:静脉动脉ECMO,静脉动脉ECMO和体外心肺复苏 (ECPR).
主要成果:
- 在协议实施后,不同ECMO类型的ECMO存活率没有显著差异.
- 静脉ECMO和ECPR患者的平均血红蛋白水平显著下降.
- 该方案在维持患者存活率方面表现出非劣势性.
结论:
- 严格的输血方案似乎是安全的,并且对ECMO患者的存活率不逊色.
- 建议进行进一步的前性随机试验,以确认ECMO患者限制性输血协议的安全性和有效性.
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