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在小儿心脏外科手术中以血小板造影为指导的手术内血小板输血

Sirisha Emani¹, Reece Donahue², Aminah Callender²

¹Department of Cardiac Surgery, Boston Children's Hospital, Boston, Massachusetts; Department of Surgery, Harvard Medical School, Boston, Massachusetts.

The Annals of thoracic surgery

|September 14, 2024

概括

使用TEG 6S最大幅度 (TEG-MA) 的血小板输血计算器可以在儿科心脏外科手术中指导输血. 这有助于通过确保足够的血小板水平来最大限度地减少术后出血,改善患者的治疗结果.

科学领域:

心血管外科心血管外科
血液学血液学血液学
儿科重症监护儿科重症监护

背景情况:

手术后出血是儿科复杂心脏手术的一个重要并发症.
血小板造影 (TEG) 可以指导输血产品以减轻出血风险.
这项研究的重点是验证基于TEG 6S最大幅度 (TEG-MA) 的血小板输血计算器.

研究的目的:

为了验证基于TEG 6S最大幅度 (TEG-MA) 的血小板输血计算器.
评估计算器在儿童心脏手术患者的手术后出血减少方面的有效性.
为了比较计算器推的输血量与外科医生自行决定的输血量.

主要方法:

对1000名接受心脏外科手术的儿科患者进行了回顾性研究.
通过手术团队进行的血小板输血量与TEG-MA计算器推的血小板输血量进行比较.
使用后勤回归来评估输血充足度与术后出血或血栓形成之间的关联.

主要成果:

较低的输血后TEG-MA (≤45毫米) 与术后出血风险增加相关 (OR,4.4).
计算器显示了与输血后测量TEG-MA (r=0.7) 的中等相关性.
如果未能达到TEG-MA≥45毫米,则显著增加出血风险 (OR,3.2).

结论:

通过TEG等定量诊断测试来定制外科手术期间的血小板输血,可以减少出血并发症.
经验证的TEG-MA计算器有助于优化血小板输血策略.
这种方法支持儿童心脏病患者更安全的手术结果.

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