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冷藏与室温血小板用于战斗创伤患者的静血
Brian C Riley1, Jimmy Phuong2, Rida A Hasan3
1University of Washington School of Medicine, Seattle, Washington, USA.
Transfusion
|June 3, 2025
概括
长达14天的冷储血小板 (CSP) 对战斗创伤患者是安全有效的,与室温血小板 (RTP) 相比,降低了死亡率. 这扩大了远程军事环境中的输血选择.
科学领域:
- 军事医学 军事医学
- 输血医学 输血医学
- 创伤护理 创伤护理
背景情况:
- 自2004年以来,室温血小板 (RTP) 已在战斗中使用,但它们的分布有限.
- 冷藏血小板 (CSP) 已被批准延长存储 (10-14天),以改善偏远地区的获取.
- 在战斗创伤中使用CSP的临床结果很少被报道.
研究的目的:
- 评估冷藏血小板 (CSP) 与战斗创伤患者的死亡率之间的关联.
- 将CSP输血与室温血小板 (RTP) 的临床结果进行比较.
主要方法:
- 对2001-2023年军事战斗伤亡记录的回顾性分析.
- 在接受CSP (10天或14天存储) 和只接受RTP的对照组之间的患者出院时的死亡率的比较.
- 使用后勤回归分析来比较治疗组.
主要成果:
- 分析了124名接受CSP的患者;CSP组的整体死亡率为16.1%,RTP对照组为13.9%.
- 输血10天CSP (adjOR=0.39) 或14天CSP (adjOR=0.41) 与显著降低的死亡率有关.
- CSP的过时率为93.4%,而RTP的过时率为75.2%.
结论:
- 长达14天的冷储血小板 (CSP) 似乎不低于短寿命的RTP.
- 使用CSP,特别是在它们的保质期结束时,表明满足了以前未得到满足的输血需求.
- 在偏远的环境中,CSP促进了及时的血小板输血,改善了患者的治疗结果,并为更广泛的紧急使用提供了进一步的评估.
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