坚持内科手术输血产品算法与心脏外科手术患者进行冠状动脉旁路移植和大动脉和/或门置换手术的输血产品减少有关:单中心观察性研究
Megan Lanigan1, Daniel Siers2, Megan Schramski2
1Department of Anesthesiology, University of Minnesota, Minneapolis, MN.
Journal of cardiothoracic and vascular anesthesia
|February 27, 2024
概括
一个基于粘弹性的算法减少了心脏手术患者的血液产品输血,包括红细胞 (RBC) 和新鲜冷血 (FFP). 然而,并没有观察到输出管时间或住院时间的显著改善.
科学领域:
- 麻醉学 麻醉学
- 输血医学 输血医学
- 心脏外科手术 心脏外科手术
背景情况:
- 心脏外科手术中的手术内输血管理是复杂的.
- 优化血液产品的使用对于患者的治疗结果和资源管理至关重要.
研究的目的:
- 评估基于粘弹性的算法在减少非红细胞 (RBC) 产品在成人心脏手术期间的有效性.
- 评估算法对输血率和临床结果的影响.
主要方法:
- 在四级学术教学医院进行前性观察性研究.
- 基于粘弹性的手术内输血算法的实施.
- 从184名心脏手术患者的输血数据与236名历史对照者的数据进行比较.
主要成果:
- 输血红细胞 (RBC) 单位显著减少43.9% (p = 0.008).
- 在新鲜冷血 (FFP),血小板和冷沉积物中观察到非显著的减少.
- 没有统计学上显著的差异在时间到输出管,再次手术出血,ICU停留时间 (LOS),或医院LOS.
- 算法坚持率为32.7%. 算法坚持率为32.7%.
结论:
- 基于粘弹性算法的实施导致减少了包装的红细胞,FPF,血小板,冷沉积物和细胞节约器的管理.
- 虽然符合算法的患者接受的输血较少,但关键的临床结果,如输出时间和LOS,与历史对照相比,没有显示出统计学上显著的改善.
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