血:说明,争议和机遇
Michael A Benson1, Deborah Tolich2, Jeannie L Callum3
1Department of General Anesthesiology, Cleveland Clinic, Cleveland, OH, USA.
Postgraduate medicine
|February 16, 2024
概括
血在医学中经常被过度使用. 本综述阐明了血应用于出血障碍和手术需要的适当用途,并强调了基于证据的指导方针,以防止不必要的输血.
科学领域:
- 输血医学是一种输血医学.
- 血液学 血液学 血液学
- 关键护理医学 关键护理医学
背景情况:
- 血是一种重要的血液制品,在全球范围内经常被过度使用.
- 目前支持最佳血利用的数据有限,导致潜在的过度使用.
- 常见的用途包括治疗出血患者的凝血病和手术前凝血优化.
研究的目的:
- 审查和定义血输血的适当指示.
- 要突出血过度使用或不适用的临床情况.
- 讨论各种医疗场景中血使用的基于证据的指导方针.
主要方法:
- 从2000年1月到2023年6月,在PubMed和谷歌学者上进行了全面的文献审查.
- 搜索术语包括"血"",新鲜冷血"",适应症"",大规模输血协议"",肝病"",华法林逆转"和"INR<2".
- 文章被选出与输血医学的相关性,额外的参考来源来自引用.
主要成果:
- 适当的血使用的关键指示包括凝血因子替代,主要出血方案,以及在肝病或使用维生素K对抗剂时管理凝血病.
- 该综述讨论了凝血因子水平,INR和适当的基于体重的血剂量之间的关系.
- 突出了确定的临床情况,其中血经常被过度或不必要地使用.
结论:
- 适当的血输血需要遵守基于证据的指导方针,以确保患者安全并优化资源利用.
- 高价值的医疗保健方法需要仔细考虑血的好处与特定临床环境中的风险.
- 新型血产品可能为输血治疗提供未来的进步,需要进一步研究.
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