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为患有严重出血的成年人提供患者血液管理指南
Biswadev Mitra1,2, Margaret Jorgensen3, Michael C Reade4,5
1Emergency and Trauma Centre, Alfred Health, Melbourne, VIC.
The Medical journal of Australia
|January 29, 2024
概括
关键出血管理的最新指南强调主要出血协议 (MHP) 和早期监测. 关键建议包括特定的血液产品比率和用于创伤和产科出血的松酸.
科学领域:
- 医学 医学 医学 医学 医学
- 血液学 血液学 血液学
- 关键的护理关键的护理
背景情况:
- 关键出血的有效管理需要一个多学科的战略,重点是血静,生理优化,和指导血液产品的利用.
- 2011年关于危急出血/大规模输血的患者血液管理指南已更新.
研究的目的:
- 为经历严重出血和大量输血的患者的管理提供最新的建议.
- 将系统审查和元分析的发现纳入临床实践指南.
主要方法:
- 进行了系统性审查,以解决预先规定的研究问题.
- 根据包含的研究证据的元分析,制定了建议.
主要成果:
- 更新的指南建议建立主要出血方案 (MHPs) 作为标准护理.
- 关键建议包括频繁监测生理,生化和凝血参数.
- 建议使用红细胞与新鲜冷血和血小板的特定比率,以及针对创伤和产科出血的及时注射tranexamic acid.
结论:
- 应在全球范围内实施主要出血协议 (MHPs) 来管理严重出血.
- 对关键生理参数的早期和频繁监测至关重要.
- 证据支持在某些关键出血场景中使用特定的血液产品比率和胺酸.
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