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在创伤患者中大规模输血激活的预测因素的识别:系统性审查和元分析
Thosapol Ueamsaranworakul1, Ratcharin Niamjumnong1, Kumpol Kornthatchapong1
1Department of Emergency Medicine, Faculty of Medicine, Thammasat University, Klong Luang, Pathum Thani, Thailand.
Journal of emergencies, trauma, and shock
|February 6, 2025
概括
在创伤患者中大规模输血协议的预测因素包括低静脉压,心率升高,血红蛋白降低和乳酸增加. 这些指标有助于指导血液控制的治疗决策.
科学领域:
- 创伤护理和紧急医疗
- 输血药物 输血药物 输血药物
- 临床决策支持 临床决策支持
背景情况:
- 在创伤中急性失血和出血需要快速恢复体积.
- 大规模输血协议 (MT) 旨在降低创伤患者的死亡率并避免过度输血.
- 识别MT协议激活的预测因素对于及时有效的患者管理至关重要.
研究的目的:
- 系统地审查和分析激活创伤患者大规模输血协议 (MTP) 的预测因素.
- 改善创伤出血管理中的临床决策和患者结果.
- 确定与MTP激活相关的关键生理参数.
主要方法:
- 对2007年至2020年间发表的研究进行系统审查.
- 包括接受MTP的15岁以上创伤患者的原始研究.
- 偏差风险评估和对效应大小的统计分析.
主要成果:
- 在424项已识别的研究中,有9项研究符合纳入标准.
- 对于MTP激活的显著预测因素包括静脉血压,心率,血红蛋白,国际正常化比率,过量和乳酸.
- 年龄和性别并不是重要的预测因素.
- 与非MTP组相比,MTP组的生存率较低.
结论:
- 低缩血压,心率升高,血红蛋白降低,INR升高,基过剩减少,乳酸盐升高与MTP的必要性相关.
- 这些生理参数是创伤中MTP激活的关键指标.
- 在接受MTP的患者中观察到较低的生存率,需要进一步调查和优化协议的使用.
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