这是一个新的措施,总结了危急疾病期间的输血实践
Nicholas A Bosch1, Anica C Law1, Zhan Shi1
1Section of Pulmonary, Allergy, Sleep & Critical Care Medicine, Department of Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA.
Transfusion
|March 22, 2024
概括
一项新的"实践中断"措施确定了特定的血红蛋白值,决定了输血红细胞的决策. 这种方法显示了输血量在7.0g/dL以下的显著增加,提供了更精确的输血实践视图.
科学领域:
- 血液学 血液学 血液学
- 临床实践指南 临床实践指南
- 医疗保健服务研究 医疗服务研究
背景情况:
- 传统的测量方法,比如平均血红蛋白度,不充分地定义了输血实践的临界值.
- 现有的方法无法确定触发红细胞 (RBC) 输血的特定血红蛋白水平.
- 为了确定这些关键值,提出了一种新型指标"实践中断".
研究的目的:
- 引入和验证用于分析红细胞输血模式的"实践中断"措施.
- 确定特定的血红蛋白度值,这些值显著影响了重症监护室 (ICU) 患者的输血决策.
- 为了将新型测量与传统的指标比较,例如平均和中位数血红蛋白度.
主要方法:
- 利用PINC人工智能数据库 (2016-2022) 对成年ICU患者进行血红蛋白测量.
- 定义"实践中断"为血红蛋白水平,在输血使用中从较高度到较低度的最大激增.
- 分析了使用医院费用代码和计算的平均/中位数输血前血红蛋白水平的输血事件.
主要成果:
- 包括1,298,367名患者和4,905,839名患者日;10.8%涉及红细胞输血.
- 总体平均和中位数输血前血红蛋白分别为8.4和8.0g/dL.
- 实践中断被确定为7.0g/dL作为关键值,输血使用从46.6%跃升至74.8%,在7.0和6.9g/dL之间.
结论:
- "实践中断"措施提供了对红细胞输血实践的更精细的理解.
- 未来的研究应该纳入这个指标,以更好地描述关于输血的临床决策.
- 这种方法提高了输血触发因素的分析,超出了简单的平均值.
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