在重症患者中使用白蛋白的效果:回顾性单中心分析
Salim Abdelhamid1,2, Rita Achermann1,2, Alexa Hollinger1,2
1Intensive Care Unit, Department of Acute Medicine, University Hospital Basel, Basel, Switzerland.
Critical care medicine
|March 19, 2024
概括
在ICU中使用白蛋白显著增加,导致由于血液稀释而导致的血红蛋白水平显著下降. 这种效应,特别是异构菌性白蛋白,可以持续超过12小时,可能会影响红细胞输血需求.
科学领域:
- 临界护理医学 临界护理医学
- 液体复苏 复苏 液体复苏 复苏
- 重症监护病房 (ICU) 管理管理
背景情况:
- 专是一种常见的合物,用于重症患者的体积扩张.
- 了解白蛋白对血红蛋白度的影响对于患者管理至关重要.
- 成人ICU中使用专蛋白的趋势需要分析.
研究的目的:
- 分析成年ICU患者对专素的使用趋势.
- 评估阿尔伯明剂对血清血红蛋白水平的影响.
- 为了评估由专辑蛋白诱导的体积膨胀的持续时间和程度.
主要方法:
- 成人ICU入院的回顾性单中心研究 (2013-2021年).
- 包括20927个入院病例;3748人接受了白蛋白.
- 在2006年小组患者中,与匹配的对照组相比,在白蛋白注射前和后对血红蛋白水平的分析.
主要成果:
- 2013年至2021年期间,重症患者的白蛋白使用量从5.0%上升到32.5%.
- 在手术患者和接受红血细胞 (RBC) 输血的患者中观察到白蛋白的使用增加.
- 在阿尔伯明剂后,平均血红蛋白降低约为5g/L.
结论:
- 专素的使用,特别是异菌溶液,会导致持续超过12小时的显著血稀释.
- 这种血液稀释可以导致血红蛋白度大幅下降.
- 增加红细胞 (RBC) 输血可能是必要的,因为白蛋白疗法可能会降低血红蛋白低于输血值.
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