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包装红细胞输血:创伤性脑损伤患者血栓形成的催化剂?

Lily Nguyen¹, Jeffry Nahmias¹, Patrick Chen¹

¹Department of Surgery, Division of Trauma, Burns and Surgical Critical Care, University of California, Irvine, Orange, USA.

|March 25, 2025

概括

早期接受输血的TBI创伤患者患有静脉血栓栓塞 (VTE) 的风险明显更高. 这种风险增加的VTE主要与输血的包装红细胞 (pRBC) 相关.

科学领域:

创伤外科手术创伤外科
血液学血液学血液学
关键护理医学关键护理医学

背景情况:

创伤性脑损伤 (TBI) 是创伤患者患病和死亡的重要原因.
静脉血栓栓塞 (VTE) 是创伤后的严重并发症,其与TBI的关联需要进一步调查.
血液产品输血在TBI患者静脉动脉突发症的发展中的作用尚未完全理解.

研究的目的:

调查血液产品输血与创伤TBI患者静脉动脉突发症发生率之间的关联.
为了确定早期输血产品是否会增加TBI患者静脉动脉突发症的风险.
为了确定与增加VTE风险相关的特定血液产品.

主要方法:

利用了创伤质量改善计划 (TQIP) 数据库 (2017-2021) 的数据.
包括被诊断患有TBI的成年患者 (≥18岁).
在到达后4小时内接受输血的TBI患者和没有接受输血的患者之间,使用双变量和多变量逻辑回归分析比较VTE发病率.

主要成果:

在451,061名TBI患者中,7.2%接受了输血.
输血患者的静脉瘤发病率较高 (7.6%与1.4%,p < 0.001),包括深静脉血栓和肺栓塞.
输血产品与静脉瘤风险增加有关 (OR 1.34),主要是由于输血红细胞 (pRBC) 输血 (OR 1.37).

结论:

创伤性创伤患者早期输血的血液产品与近50%的风险增加有关.
增加的VTE风险似乎主要与输血红细胞 (pRBC) 的输血有关.
这些发现强调了对TBI患者输血策略的仔细考虑的重要性,以减轻VTE风险.

关键词:

创伤性脑损伤是一种创伤性脑损伤.深静脉血栓形成的原因是深静脉血栓形成.肺栓塞肺栓塞是一种肺栓塞.输血输血输血输血静脉血栓塞栓症是一种静脉血栓塞栓.

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