在重症患者中遵守限制性红细胞输血策略:一项观察性研究
Martin F Bjurström1,2, Ylva C Linder3, Jens Kjeldsen-Kragh3
1Department of Intensive and Perioperative Care, Skåne University Hospital and Lund University, Lund, Sweden.
Acta anaesthesiologica Scandinavica
|March 7, 2024
概括
在重症监护病房实施限制性红细胞 (RBC) 输血策略显著降低了红细胞的使用和成本. 这种变化还降低了血红蛋白触发水平,并改善了对输血指南的遵守.
科学领域:
- 关键护理医学 关键护理医学
- 输血医学 输血医学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 限制性红细胞 (RBC) 输血策略已被证明是安全有效的,与严重病患者的自由主义策略相比.
- 2020年9月,一个三级护理重症监护病房 (ICU) 采用了70g/L的限制性红细胞输血门.
- 实施涉及教育举措,如讲座和网络研讨会.
研究的目的:
- 评估实施限制性红细胞输血策略对红细胞使用的影响.
- 为了评估血红蛋白触发水平的变化和实施后对这些触发的坚持.
- 确定限制性输血策略的成本效益.
主要方法:
- 一项基于注册的观察性研究,比较了严重病情的成年患者的实施前和后队列.
- 对红细胞输血量,血红蛋白触发水平和坚持率的分析.
- 基于减少红细胞输血量进行成本分析.
主要成果:
- 红细胞输血量减少了大约50% (6120毫升 vs 3010毫升每100个入院日).
- 处方和实际血红蛋白触发水平的中位数显著下降 (分别为90g/L,80g/L和89g/L,83g/L).
- 遵守处方输血触发剂的情况有所改善,不遵守的日数从23%降至14%.
结论:
- 实施严格的输血策略导致使用红细胞和相关成本的持续减少.
- 这一策略导致了较低的处方和实际的血红蛋白触发水平.
- 在改变策略后,观察到更好地遵守输血指南.
关键词:
坚持性 坚持性病情严重,病情危急.红细胞输血 红细胞输血准则 准则 准则医疗保健 经济 经济 医疗保健重症监护医学的重症监护医学的医药.红细胞输血输血 红细胞输血输血费用 输血费用 输血费用输血策略是输血策略.更多相关视频
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