在状细胞病患者中优化单针红细胞交换
Lilora Kearney1, Regina Bosnick1, Haley Phillips2
1Department of Nursing, St. Jude Children's Research Hospital, Memphis, Tennessee, USA.
Journal of clinical apheresis
|April 29, 2024
概括
状细胞疾病 (SCD) 患者经历单针红细胞交换 (SN-RCE) 脱血经历了血液溶解. 调整抗凝剂的流量和输入速率可以在化过程中解决这些溶血事件.
科学领域:
- 血液学 血液学 血液学
- 阿菲雷西斯技术的技术
- 状细胞疾病管理管理
背景情况:
- 状细胞疾病 (SCD) 的特点是高凝血状态,复杂化了非过程.
- 在SCD患者中,单针红细胞交换 (SN-RCE) 程序与溶血事件有关.
- 这些事件表现为变色的血,离心机中改变的接口,以及仪器报警,表明在血线中检测到红细胞 (RBC).
研究的目的:
- 在SCD患者的SN-RCE期间调查血液溶解事件的原因.
- 确定优化SN-RCE以防止血液溶解的策略.
- 为了评估修改的异位参数在预防血液溶解中的有效性.
主要方法:
- 追溯分析62个在15个月内进行的SN-RCE程序.
- 在SN-RCE和双针RCE程序之间比较警报频率.
- 修改了阿菲雷斯参数:增加了抗凝剂剂量 (输入/AC比从13到8) 和减少了输入速率.
主要成果:
- 在SN-RCE期间,4名患者发生了6次溶血事件,与血线中的红细胞相关的警报.
- 血液溶解源于非瑞斯仪器,而不是患者的外周血液.
- 与双针RCE (2.7%) 相比,SN-RCE (20.4%) 的血液溶解报警频率明显高,可能是由于红细胞凝聚.
- 调整后的抗凝剂和输入速率被很好地容忍,没有进一步的血液溶解.
结论:
- 在SCD患者的SN-RCE期间发生的溶血事件与仪器相关,可能是由红细胞凝结引起的.
- 优化输入/交流比率和输入速率可以有效地防止SN-RCE期间的血液溶解.
- 修改后的阿菲雷斯协议提高了SCD患者SN-RCE的安全性和效率.
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