维持以全血为中心的输血改善了在出血复苏时的生存率
Griffin J Feinberg1, Anastasia C Tillman, Marcelo L Paiva
1From the Department of surgery (G.J.F., A.C.T., M.L.P., B.E., S.N.L., T.K.), Brown University, Alpert School of Medicine, Providence, Rhode Island; Department of Emergency Medicine (A.M.H.), and Department of Surgery (A.M.H.), University of New Mexico School of Medicine, Albuquerque, New Mexico.
The journal of trauma and acute care surgery
|December 26, 2023
概括
在创伤复苏中,包装红细胞与全血 (WB) 的比率较高与死亡率的增加有关. 在接受WB的创伤患者中, 3:1或更低的比率似乎是改善生存的最佳选择.
科学领域:
- 创伤复苏 创伤复苏
- 血液性冲击管理 血液性冲击管理
- 血液产品输血策略 输血策略
背景情况:
- 全血 (WB) 输血改善创伤复苏生存率.
- 在新兴输血中,包装红细胞 (pRBC) 与WB的最佳比例仍未确定.
- 这项研究探讨了低PRBC/WB比率提高创伤患者的生存率的假设.
研究的目的:
- 为了确定pRBC与WB的最佳比例,用于新出现的创伤输血.
- 评估不同pRBC/WB比率与24小时死亡率之间的关联.
- 为基于证据的创伤复苏方案提供信息.
主要方法:
- 对2021年创伤质量改善计划 (TQIP) 数据库的分析.
- 包括接受紧急手术以控制出血并在4小时内输血的患者.
- 通过pRBC/WB比率的分层和逻辑回归来评估死亡率的几率.
主要成果:
- 分析了3,884名接受WB治疗的患者队列.
- 较高的pRBC/WB比率与24小时死亡率显著增加相关 (p=0.0001).
- 一个pRBC/WB比率为3:1或更低被确定为一个最佳的切断点.
结论:
- 升高的PRBC/WB比率降低了WB在创伤复苏中的生存益处.
- 优化pRBC/WB比率对于改善创伤患者的治疗结果至关重要.
- 进一步的研究应该专注于改进这些输血比率.
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