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血输血与儿科创伤性脑损伤死亡率之间的时间有限关联

Leah Furman¹, Erin V Feeney, Barbara A Gaines

¹From the Department of Surgery (L.F., E.V.F.), University of Pittsburgh Medical Center; Trauma and Transfusion Medicine Research Center (L.F., E.V.F., C.M.L.), University of Pittsburgh, Pittsburgh, Pennsylvania; Division of Pediatric Surgery, Department of Surgery (B.A.G.), University of Texas Southwestern Medical Center, Dallas, Texas; and Department of Surgery and Critical Care Medicine (C.M.L.), University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.

The journal of trauma and acute care surgery

|June 6, 2025

概括

在严重创伤性脑损伤 (TBI) 的儿童中,早期血输血与4小时内死亡的风险降低有关. 这种生存益处不会超过24小时,这表明干预的关键窗口.

科学领域:

儿科重症监护儿科重症监护
创伤外科手术是什么
紧急医疗紧急医疗

背景情况:

创伤性脑损伤 (TBI) 是儿童死亡的主要原因.
在患有TBI的成年人中,医院前血输血与较低的死亡率有关.
早期血注射对儿科TBI结局的影响尚不清楚.

研究的目的:

研究早期血输血对严重TBI儿童死亡率的影响.
为了确定早期的血给药是否会影响4小时,24小时和30天死亡率.
评估血复苏与儿科重度TBI的存活率之间的关联.

主要方法:

使用国家创伤数据库 (2020-2022) 进行回顾性队列研究.
包括1至17岁的患有严重TBI的儿童 (头部AIS分数为4-5).
在抵达后4小时内分析血输血,使用Cox比例危险模型,调整多种临床因素.

主要成果:

在14691名符合条件的儿童中,有1594人 (10.9%) 接受了早期血.
早期的血给药与显著降低4小时死亡风险相关 (HR=0.610,p=0.005).
这种与降低死亡率的关联在24小时 (HR=0.894) 或30天 (HR=1.132) 后没有持续.

结论:

在儿童重度TBI早期血输血与4小时死亡率显著降低有关.
早期血的生存益处似乎仅限于最初的4小时.
需要进一步的前性研究来证实这些发现并指导临床实践.

关键词:

血等离子体的使用方法儿科创伤儿童创伤血复苏是用血复苏的方式进行的.创伤性脑损伤是一种创伤性脑损伤.

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