在受伤的儿童中,全血对总输血体积的比率:国家数据库分析分析
Insiyah Campwala1, Ander Dorken-Gallastegi, Philip C Spinella
1From the Department of Surgery (I.C., A.D.-G., P.C.S., J.B.B., C.M.L.) and Department of Critical Care Medicine (P.C.S., J.B.B., C.M.L.), Trauma and Transfusion Medicine Research Center, University of Pittsburgh, Pittsburgh, PA.
The journal of trauma and acute care surgery
|September 13, 2024
概括
在儿童创伤患者的全血 (WB) 复苏显著降低死亡率. 较高的全血与总输血体积的比率与更高的生存率相关.
科学领域:
- 儿科创伤复苏儿童创伤复苏
- 血液输血 医学 输血 医学
- 关键护理医学 关键护理医学
背景情况:
- 全血 (WB) 复苏正在创伤中心获得吸引力,因为其安全性和潜在的好处超过组件疗法 (CT).
- 关于儿科患者的WB体积和整体输血体积 (WB/TTV比率) 之间的剂量反应关系的数据有限.
研究的目的:
- 评估全血和受伤儿童的死亡率之间的关联.
- 研究全血与输血总体积比率 (WB/TTV) 对儿科创伤患者结局的影响.
主要方法:
- 从美国创伤数据库对4,323名儿童患者 (<18岁) 的回顾性分析,这些患者在抵达后4小时内接受输血.
- 多变量分析评估了WB和WB/TTV比率对4小时和24小时死亡率的影响.
- 来自美国外科医生学院创伤质量改善计划的数据.
主要成果:
- 与仅CT接受者相比,WB接受者更有可能受到冲击,并且受伤严重程度得分更高.
- 任何WB输血与显著降低4小时死亡率 (aOR0.58) 和24小时死亡率 (aOR0.46) 的几率有关.
- 每增加10%的WB/TTV比率都与24小时死亡率下降9%相关 (aOR为0.91).
结论:
- 全血复苏独立地与小儿创伤患者24小时死亡率的降低有关.
- 增加全血在整体复苏体积中的比例 (WB/TTV比率) 表明了逐步的生存益处.
- 研究结果支持在儿科创伤复苏方案中使用全血和优化其比率.
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