重症监护室的输血实践:一个前性观察双国研究
Andrew W J Flint1,2,3, Alexis Poole2,4, Senta Jorinde Raasveld5,6
1Transfusion Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
输血在重症监护室 (ICU) 很常见,但实践在很大程度上存在差异,并且经常不遵循指导方针. 每名患者输血的血液制品数量有所增加,这凸显了需要进一步的研究.
科学领域:
- 关键护理医学 关键护理医学
- 输血医学 输血医学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 输血是重症监护室 (ICU) 的关键干预措施,但它们的应用往往与既定的指导方针不一致.
- 人们对ICU内输血实践的最新趋势和变化了解有限.
研究的目的:
- 描述澳大利亚和新西兰ICU当前的输血实践.
- 评估这些做法在不同地点的变化.
- 将目前的输血实践与国家指导方针和历史数据进行比较.
主要方法:
- 一项前性,多中心,双国观察性研究,涉及澳大利亚和新西兰的40个ICU.
- 包括所有在一周时间内 (2021年10月至2022年7月) 住院的成年ICU患者,直到出院或28天后进行跟踪.
- 收集关于输血类型,临界值,原因,粘弹性静血试验 (VHA) 的使用和实践变化的数据.
主要成果:
- 在927名患者中,23.4%接受了输血 (红细胞,血小板,新鲜冷血,冷沉积物).
- 输血与国家指导方针的一致性在红细胞 (89.0%) 中很高,但在血小板 (30.3%),FFP (27.4%) 和冷 (20.0%) 中较低.
- 与2008年相比,患者接受了更多的RBC和FFP单位,并增加了RBC,血小板和FFP的输血间位点变化.
结论:
- 在ICU的输血实践是异质的,经常偏离国家指导方针.
- 每位患者输血的血液单位数量有所增加.
- 需要进一步的证据来优化ICU环境中的输血策略.
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Published on: January 16, 2019
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