快速是好的,但准确性是一切:通过点诊疗检测做出手术内输血决策
Lachlan F Miles1, Erica M Wood2
1Department of Critical Care, Melbourne Medical School, The University of Melbourne, Melbourne, VIC, Australia; Department of Anaesthesia, Austin Health, Heidelberg, VIC, Australia.
British journal of anaesthesia
|January 29, 2025
概括
与实验室结果相比,诸如HemoCue®,i-STATTM和Rad-67TM之类的临床血红蛋白测试设备显示出可变性. HemoCue®证明了引导不适当的红细胞输血的风险最低.
科学领域:
- 临床诊断 临床诊断 临床诊断
- 医疗器械 医疗器械 医疗器械
- 输血药物 输血药物 输血药物
背景情况:
- 准确的血红蛋白测量对于临床决策至关重要,特别是在输血方面.
- 护理点 (POC) 测试提供了快速的结果,但需要与标准方法进行验证.
研究的目的:
- 为了比较三个POC血红蛋白装置 (HemoCue®,i-STATTM,Rad-67TM) 与实验室测量的精度.
- 评估这些POC设备在指导红细胞输血决策中的实用性,在接受重大非心脏手术的成年人中.
主要方法:
- 一项前性队列研究,涉及接受重大非心脏手术的成年人.
- 来自动脉或中央静脉样本的POC血红蛋白测量与标准实验室血红蛋白测量进行了比较.
- 专注于100克以下的血红蛋白结果L-1.1.
主要成果:
- 没有一个POC设备达到与实验室结果一致的可接受限度 (±4g L-1).
- 没有任何一种设备始终高估或低估了实验室血红蛋白值.
- HemoCue®显示导致不适当的红细胞输血的可能性最低.
结论:
- POC血红蛋白测试设备表现出显著的变化,可能不符合输血决策的准确性标准.
- 临床医生必须考虑影响POC血红蛋白测试准确性的患者,样品和设备特定因素.
- 需要进一步评估,以优化POC设备的使用,以指导输血策略.
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