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HMGB-1作为主要出血的预测因素,需要在严重创伤中激活大规模输血协议
Michal Frelich1,2, Marek Bebej1, Jan Pavlíček3,4
1Department of Anaesthesiology and Intensive Care Medicine, University Hospital Ostrava, Ostrava, Czech Republic.
Scientific reports
|February 7, 2025
概括
在创伤患者中高水平的高流动性组框1 (HMGB-1) 预测需要大规模输血协议 (MTP). HMGB-1水平与复苏所需的血液产品体积相关.
科学领域:
- 创伤和紧急医疗医学
- 生物化学 生物化学
- 关键的护理关键的护理
背景情况:
- 大规模出血是重创死亡的主要原因,及时干预至关重要.
- 大规模输血协议 (MTP) 的早期激活显著提高了生存率.
- 高流动性组盒1 (HMGB-1) 在严重创伤期间释放,并与炎症和凝血病有关.
研究的目的:
- 评估入院高流动性组盒1 (HMGB-1) 水平对创伤患者MTP激活的预测值.
- 评估HMGB-1水平与注射的血液制品数量之间的相关性.
主要方法:
- 一项前性单中心研究的回顾性分析,涉及104名严重创伤患者 (ISS>16).
- 在入院时采集的血液样本中测量HMGB-1水平.
- 关于MTP激活和监测6小时内服用的血液制品和纤维素原的文件.
主要成果:
- 与没有MTP激活 (21.1μg/L) 的患者相比,需要MTP激活的患者的HMGB-1水平显著更高 (84.3μg/L).
- HMGB-1显示了MTP激活 (AUC 0.84) 的良好预测性能,截止值为30.55μg/L.
- HMGB-1水平与红细胞,新鲜冷血,血小板和纤维素素的数量显著相关.
结论:
- 入院HMGB-1水平是严重出血的可靠预测指标,需要在急诊室激活MTP.
- HMGB-1水平与血液产品和纤维素原复苏在出血性休克最初6小时所需的程度相关.
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