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大规模输血协议的重新激活作为医生团队在受伤后未经选的新标志
Michael B Weykamp1, Zhinan Liu2,3, Lauren R Fernandez2
1Department of Surgery, Harborview Medical Center, University of Washington, Seattle, Washington, USA.
Transfusion
|January 23, 2024
概括
许多创伤患者需要第二次大规模输血协议 (MTP) 激活. 老年患者和那些在轮班变更期间出现的患者有更高的MTP重新激活的风险,这表明潜在的不足.
科学领域:
- 创伤护理 创伤护理
- 输血医学 输血医学
- 紧急医疗 紧急医疗
背景情况:
- 创伤中心的目标是过度选患者,以确保适当的护理.
- 很大一部分患者需要在24小时内进行第二次大规模输血协议 (MTP) 激活.
- 这项研究研究了与MTP重新激活相关的因素.
研究的目的:
- 在创伤患者中识别与大规模输血协议 (MTP) 再激活相关的因素.
- 分析MTP重新激活对资源利用和患者治疗结果的影响.
- 通过对输血数据的分析,改进创伤护理协议.
主要方法:
- 从2019-2021年开始对创伤患者进行MTP激活的回顾性队列研究.
- 链接输血服务和创伤登记记录以识别单人与重新激活队列.
- 使用统计分析,包括多变量回归来比较人口统计,伤害严重程度和结果数据.
主要成果:
- 在1884名创伤患者中,7.5%需要MTP重新激活.
- 与重新激活相关的因素包括年龄较大,受伤严重程度得分 (ISS) 较高,腿部受伤以及早上班换班的表现.
- 再活化的患者使用了更多的红细胞 (RBC) 并有更长的ICU停留时间.
结论:
- 老年患者和轮班交换期间出现的患者由于复杂的受伤模式而面临低位的风险.
- MTP的重新激活凸显了初始创伤评估和分类中的潜在缺口.
- 输血服务数据为改善创伤护理质量提供了宝贵的见解.
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