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在重症监护室的输血实践:澳大利亚和新西兰的一项点患病率研究

Andrew W J Flint^1,2,3,4, Karina Brady¹, Erica M Wood^1,5

¹Transfusion Research Unit, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.

Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine

|January 18, 2024

概括

澳大利亚和新西兰重症监护室 (ICU) 的输血实践显示,红细胞 (RBC) 输血的坚持很高,但对其他血液制品的调整很差. 粘弹性血液静止测试 (VHA) 在指导输血决策时未得到充分利用.

科学领域:

关键护理医学关键护理医学
输血医学输血医学
临床病理学临床病理学

背景情况:

目前在重症监护室 (ICU) 的输血实践需要根据国家指导方针进行评估.
了解粘弹性静血试验 (VHA) 在指导输血决策中的利用对于优化患者护理至关重要.

研究的目的:

描述澳大利亚和新西兰ICU当前的输血实践.
将这些做法与国家输血指南进行比较.
评估VHA在指导输血决策中的使用情况.

主要方法:

进行了一项前性,多中心,双国点患病率研究.
我们收集了2021年在一天内进入参与ICU的成年患者的数据.
输血类型,数量,临床原因,触发因素以及使用抗血小板药物,抗凝固药物和VHA的情况都被记录下来.

主要成果:

在712名患者中,71人 (10%) 接受了输血. 接受输血的患者患病严重程度得分较高.
红细胞 (RBC) 输血显示了高标准的遵守 (98.6%).
血小板 (61.6%),新鲜冷血 (FFP) (28.6%) 和冷流体 (20%) 输血的准则遵守率较低. 在82.4%的部位中,有VHA可用,但仅在6.6%的输血事件中使用.

结论:

对于非RBC产品的输血决定经常偏离国家指南.
粘弹性血液静止测试 (VHA) 是广泛可用的,但在指导ICU内的输血实践中未得到充分利用.
需要更好的证据来指导ICU环境中的输血策略.

关键词:

21 血液学血液学 4 麻醉和重症监护 4.24 重症监护室的重症监护室

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