通过实施患者血液管理计划,改善心胸外科的输血实践
Hee Jung Kim1, Hyeon Ju Shin2, Suk Woo Lee2
1Department of Thoracic and Cardiovascular Surgery, Korea University College of Medicine, Seoul, Korea.
Journal of chest surgery
|April 8, 2024
概括
患者血液管理 (PBM) 通过降低血红蛋白值和增加适当的输血,改善了心胸外科手术中的红细胞输血实践. 临床结果保持相似,表明输血效率有所提高,而不会影响患者的安全.
科学领域:
- 心胸外科手术 心胸外科手术
- 输血医学 输血医学
- 患者血液管理患者血液管理
背景情况:
- 患者血液管理 (PBM) 计划旨在优化红细胞 (RBC) 输血实践.
- 在高风险的手术环境中,如心胸外科手术,有效的PBM策略至关重要.
研究的目的:
- 评估全面的PBM计划对红细胞输血实践和心胸外科手术的临床结果的影响.
- 评估PBM实施后的输血触发因素和适当性的变化.
主要方法:
- 对2802名接受心胸外科手术的患者进行了回顾性分析.
- PBM计划的组成部分包括输血监测,医疗团队教育和医生反.
- 检查了血红蛋白值,输血的适当性和临床结果 (死亡率,停留时间,并发症).
主要成果:
- 红细胞输血后PBM实施的血红蛋白值显著下降 (从8.7g/dL降至8.0g/dL).
- 适当的红细胞输血比例显著增加 (从23.9%增加到58.2%).
- 心脏手术患者住院时间缩短 (p<0.001),其他临床结果没有显著变化.
结论:
- 在心胸外科手术中,PBM的实施成功优化了红细胞输血实践.
- 在没有对关键临床结果产生负面影响的情况下,实现了输血效率的提高.
- 输血管理是一种有效的策略,可以提高输血的适当性,并可能减少医疗保健资源的利用率.
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