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在1级创伤中心重伤患者的输血实践

Aparna Krishna¹, Arulselvi Subramanian², Rahul Chaurasia¹

¹Department of Transfusion Medicine, Jai Prakash Narayan Apex Trauma Center, AIIMS, New Delhi, India.

Journal of emergencies, trauma, and shock

|July 29, 2024

概括

这项研究确定了创伤患者,特别是铁路轨道受伤患者血液成分的特定输血触发因素. 这些发现可以为低资源环境中的基于证据的输血实践提供信息.

科学领域:

创伤复苏创伤复苏复苏
输血医学输血医学
紧急医疗紧急医疗

背景情况:

低收入和中等收入国家的急性创伤复苏缺乏基于证据的输血指南.
需要定义血液成分输血的最佳比率,体积和触发因素.

研究的目的:

调查不同伤害机制和设施间转移状态的血液使用模式.
为了确定红细胞,血,血小板和冷沉积物的特定输血触发器.

主要方法:

在一级创伤中心进行了前性观察性研究.
收集了人口统计,受伤,临床状况,实验室值和输血数据.
多变量逻辑回归确定了输血触发因素和死亡率预测因素.

主要成果:

在986名严重受伤的患者中,80%是男性,92%遭受了重创伤,主要是头部受伤.
铁路上的伤害需要最高的输血量 (包装红细胞,血,血小板,冷沉积物).
确定了关键的输血触发因素:PRBCs的血红度<32.08%,血PT>16.9s,血小板数<130 lakh,MAP<89.7 mmHg和PT>18.2s.

结论:

铁路轨道受伤,特别是下肢受伤,显著推动了输血需求.
确定的触发因素和切断点可以促进输血预测模型和智能手机应用程序的开发.

关键词:

死亡率死亡率死亡率结果结果结果结果.严重受伤的严重受伤.输血可以触发输血触发器.创伤输血输血

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