使用快速输注器输血ABO小不相容血小板的安全性
Yujung Jung1,2, Oscar Luo3, Nina Sen1
1Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, USA.
Transfusion
|February 1, 2024
概括
在快速输注器中将ABO不兼容的血小板与红细胞 (RBC) 混合是安全的. 这项研究没有发现显著的体外血解,支持快速输注器用于静血复苏,无论血小板兼容性如何.
科学领域:
- 输血医学 输血医学
- 血液学 血液学 血液学
- 关键的护理关键的护理
背景情况:
- 快速输注器是安全的血小板的管理.
- 通过快速输注器输注 ABO 不兼容血小板与红细胞 (RBC) 的安全性尚未得到充分证实.
- 理论上存在血液溶解的风险,因为血小板血中的异凝素与红细胞相互作用.
研究的目的:
- 用快速输注器研究输注ABO不兼容血小板与红细胞的临床意义.
- 要确定在快速输注器中混合ABO不兼容的血小板和红血细胞是否会在体外诱导血液溶解.
主要方法:
- 进行了七项体外研究,包括ABO不兼容 (A型红细胞/O型血小板) 和对照组.
- 测量了血小板单位中的抗A标位.
- 红细胞和血小板单位在快速输注器中混合,并化30分钟.
- 血液溶解通过自由血红蛋白度,血液溶解检查,直接抗球蛋白试验 (DAT) 和直接凝结来评估.
主要成果:
- 混合后的DAT在所有样本中对IgG呈阳性,在大多数样本中对补充剂呈弱阳性.
- 自由血红蛋白的变化很小 (-2.2到+3.4毫克/分升).
- 血液溶解检查是负的或只有轻微的阳性,与对照没有显著差异. 抗A标位与血液溶解没有相关性.
结论:
- 在快速输注器中将ABO不兼容的血小板与红细胞混合并不会诱导显著的体外血液溶解.
- 这些发现支持使用快速输注器进行静血复苏,无论血小板和红细胞之间的ABO兼容性如何.
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