血液制品的使用显著减少,相同的早期结果:在接受开放心脏手术的婴儿中,血液的保存
Lyubomyr Bohuta1, Titus Chan2, Kevin Charette3
1Division of Cardiac Surgery, Seattle Children's Hospital, Seattle, Wash.
JTCVS open
|January 9, 2025
概括
一个血液节约计划显著减少了接受开放心脏手术的婴儿捐献血液产品的使用. 早期的临床结果没有受到影响,这表明小儿心脏手术患者的安全有效策略.
科学领域:
- 儿科心脏手术 儿科心脏手术
- 输血医学 输血医学
- 患者血液管理患者血液管理
背景情况:
- 接受开放心脏手术的婴儿通常需要捐献者血液产品.
- 优化血液产品的使用对于患者安全和资源管理至关重要.
- 评估血液保存策略对于改善外科手术结果至关重要.
研究的目的:
- 评估血液节约计划对捐献者血液产品利用的影响.
- 评估开放心脏手术后婴儿早期临床结果.
- 分析随着时间的推移输血产品的趋势.
主要方法:
- 对409名接受开放心脏手术的婴儿 (<1岁) 进行了回顾性审查.
- 研究分为4个时代:基线 (传统管理) 和3个时代的不断发展的血液保护.
- 计算每次住院输血的血液产品总体积,并将其索引为体重.
主要成果:
- 血液产品的中位数体积从128毫升/公斤显著下降到21毫升/公斤跨时代 (P < .01).
- 在术后机械呼吸,ICU/住院时间或死亡率 (P > .05) 中没有发现显著差异.
- 多变量分析证实,在以后的时代,血液产品暴露的几率降低了.
结论:
- 血液节约可以显著减少在婴儿开放心脏手术中使用血液产品,而不会影响早期的结果.
- 这种策略在各种类别的外科复杂性上是有效的.
- 需要进一步的研究来确认长期的临床影响.
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