在重症监护病房进行血输血.
Maite M T van Haeren1,2, Senta Jorinde Raasveld1,2, Sanne de Bruin1
1Department of Intensive Care, Amsterdam University Medical Centers, Amsterdam, the Netherlands.
Transfusion
|December 19, 2024
概括
血输血在ICU中很常见,超过三分之一的输血是不必要的,因为没有出血的原因. 提高对血使用指南的遵守率至关重要.
科学领域:
- 关键护理医学 关键护理医学
- 输血医学 输血医学
- 血液学 血液学 血液学
背景情况:
- 目前的指导方针建议在非出血的重症监护室 (ICU) 患者中不使用预防性血.
- 这项研究评估了ICU的全球血输血实践及其遵守现有指南的情况.
研究的目的:
- 评估全球ICU患者血输血的发病率和症状.
- 确定当前的血输血实践与既定临床指南的一致性.
主要方法:
- 一个国际,前性,观察性队列的子研究.
- 主要结局包括ICU内血输血率,所有血液产品事件中血事件的比例,以及每事件的单位.
- 二次结局主要集中在输血指示,国际规范化比率/前血红素时间 (INR/PT) 和非出血指示.
主要成果:
- 在3643名ICU患者中,有10%接受了血输血 (547例,占所有输血的18%).
- 37%的输血用于非出血的指示,往往具有低的输血前INR (<3.0或<1.5).
- 超过一半的事件没有说明INR/PT的指导方针,27%的事件缺乏输血前测试.
结论:
- 血输血经常在ICU中进行,其中很大一部分用于非出血指示,这表明潜在的可避免性.
- 观察到对输血指示和输血前检测 (INR/PT,VHA) 的指导方针的不一致遵守.
- 为了优化血输血实践和在重症监护机构实施指南,需要进一步的研究和教育.
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