新生儿重症监护室红细胞输血:全国性的观察队列研究
Lisanne Elise Heeger1,2, Camila Caram-Deelder3, Suzanne Gunnink4,5
1Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands l.e.heeger@lumc.nl.
Archives of disease in childhood. Fetal and neonatal edition
|January 17, 2025
概括
新生儿重症监护室 (NICU) 输血红细胞 (RBC) 在荷兰中心之间显示出显著的差异,即使是在国家指导方针之后. 过早出生的婴儿和经常抽血的婴儿接受了更多的输血.
科学领域:
- 新生儿医学 新生儿医学
- 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:
- 2019年修订的国家输血指南旨在在新生儿重症监护室 (NICU) 标准化红细胞 (RBC) 输血.
- 了解当前的输血实践和变化对于改善患者护理和资源配置至关重要.
研究的目的:
- 评估指南实施后荷兰NICU中红细胞输血的利用率和全国范围的变化.
- 确定与极早新生儿使用红细胞输血相关的因素.
主要方法:
- 进行了一项回顾性观察性队列研究.
- 在荷兰NICU2020年入院的怀孕32周以下的新生儿被随机选择.
- 关键结果包括新生儿接受输血的比例和每新生儿输血的数量.
主要成果:
- 在762名新生儿中,34%的新生儿至少接受过一次红细胞输血,中心变化为20%至50%.
- 47%的输血超过了推值,有显著的中心间变化 (15%至719%).
- 较高的输血量与累积抽血量和较低的妊娠年龄相关.
结论:
- 尽管有国家指导方针,但在荷兰NICU中,红细胞输血实践仍然存在显著差异.
- 极端早产和累积抽血与增加的红细胞输血使用有关.
- 基准对比输血实践可以确定需要改进的领域,并可能减少不必要的变化.
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