在分娩中使用细胞救援的当前概念
Vanessa Neef1, Patrick Meybohm2, Kai Zacharowski1
1Goethe University Frankfurt, University Hospital, Department of Anesthesiology, Intensive Care Medicine and Pain Therapy.
Current opinion in anaesthesiology
|February 23, 2024
概括
严重的母体出血是导致死亡的主要原因. 建议进行细胞救援,以保持患者的血液体积,并减少在产科手术期间对输血的需求.
科学领域:
- 产科和妇科 产科和妇科
- 麻醉学 麻醉学
- 血液学 血液学 血液学
背景情况:
- 严重的孕产妇出血是全球孕产妇死亡的主要原因.
- 在过去的20年里,患者血液管理策略已经提升了患者的护理和安全.
- 建议在血液损失>500毫升的手术中进行细胞救援,以保持自身血液体积.
研究的目的:
- 审查当前证据和围绕细胞救援在产科使用的争议.
- 讨论细胞救援在治疗母亲出血中的好处.
- 为了解决关于产科患者细胞救援的历史问题和最近的发现.
主要方法:
- 审查最近的医学文献和指导方针.
- 关于细胞救援在产科中的安全性和有效性的证据分析.
- 讨论成本效益和实际实施.
主要成果:
- 多个医学协会和国际指导方针支持对母体出血进行细胞救援.
- 没有报告与细胞挽救相关的胚胎液栓塞 (AFE) 的确诊病例.
- 细胞救援是高风险条件的成本效益,如胎盘增生谱系障碍.
结论:
- 在手术期间的细胞救援有效地保持了自身血液体积,并减少了全原红细胞 (RBC) 输血需求.
- 在产科中进行细胞救援 (AFE, alloimmunization) 的历史禁忌没有得到当前证据的支持.
- 建议在产科环境中自由使用细胞救援,以建立多专业经验并改善患者的治疗结果.
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