冷血小板输血:液体加热器对血小板功能的影响
Diana J Valencia Morales1, Allan M Klompas1,2, Jenna M Torbenson1
1Department of Anesthesiology and Perioperative Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota, USA.
Transfusion
|December 20, 2023
概括
冷储血小板 (CSP-I) 显示在加热后腺二酸盐 (ADP) 聚合减少. 这表明变暖可能会影响血小板功能,这对于使用这些血液成分进行出血复苏至关重要.
科学领域:
- 输血医学 输血医学
- 血液成分加工 血液成分加工
- 血液静止和血栓形成
背景情况:
- 美国FDA允许冷藏血小板 (CSP) 的变异.
- 液体加热装置通常用于在出血复苏期间的血液成分.
研究的目的:
- 评估血暖装置对两种冷藏血小板 (CSP-I和CSP-D) 功能的影响.
- 通过Ranger血热装置评估输液前和后的血小板聚合度.
主要方法:
- 病原体减少的血小板单元被存储为CSP-I (1-6°C) 或CSP-D (20-24°C5天,然后1-6°C).
- 使用阿拉基酸 (AA),腺二酸 (ADP) 和原激动剂进行了聚合计.
- 血小板样本在经过Ranger血暖装置之前和之后进行了测试.
主要成果:
- 对所有激动剂,CSP-I单位显示出高聚合反应.
- 在CSP-I中,在升温后观察到ADP诱导的聚合显著减少 (55.1±23.2到33.5±14.6,p<.001).
- 在CSP-I热后,没有发现AA或原诱导聚合的显著变化. CSP-D单位的聚合率较低,一些单位表现出凝血.
结论:
- 通过Ranger设备加热CSP-I显著减少了ADP诱导的血小板聚合.
- 血小板功能,特别是ADP诱导的聚合,可能会因加热装置而改变.
- 需要进一步的研究来了解气候变暖引起的CSP功能变化的临床影响.
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