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输血动力学对重大损伤后的炎症反应的影响
Patrick R Carney1, Ben L Zarzaur, John B Holcomb
1From the Department of Surgery (P.R.C., B.L.Z., S.A.S.), University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin; Department of Surgery (E.E.F., C.E.W.), University of Texas Health Science Center at Houston, Houston, Texas; and Department of Surgery (J.B.H.), University of Alabama at Birmingham, Birmingham, Alabama.
输血动力学,不仅仅是体积,影响创伤后免疫反应. 快速服用血液制品与促炎和抗炎细胞因子的显著变化相关,影响患者的治疗结果.
科学领域:
- 创伤和紧急医疗医学
- 免疫学 免疫学 免疫学
- 关键的护理关键的护理
背景情况:
- 在重大创伤后,先天性免疫反应失调是常见的.
- 细胞因子是关键的调解者,激活免疫细胞,如中性粒细胞和巨细胞.
- 了解复苏对细胞因子概况的影响对于创伤护理至关重要.
研究的目的:
- 研究血液输血的时间 (动力学) 如何影响创伤患者的细胞因子反应.
- 为了确定输血动力学是否影响输血量或损伤严重程度之外的炎症.
主要方法:
- 实用性,随机化最佳血小板和血比率数据集的回顾性分析.
- 量化输血动力学使用关键的管理门事件在三个时间间隔的伤害后.
- 通过使用多变量线性生长模型,评估了72小时的纵向细胞因子反应.
主要成果:
- 观察到促炎性细胞因子 (IL-6,IL-8) 和抗炎性细胞因子 (IL-1ra,IL-10) 的显著增加.
- 关键化学因子显示显著增加 (IP-10,MCP-1,MIP-1β) 或减少 (CXCL10).
- 在增长因子水平上没有发现显著变化.
结论:
- 包装红细胞的输血动力学与受伤后改变的细胞因子表达有关.
- 这些细胞因子转移可能会显著影响免疫反应的程度和协调.
- 澄清复苏组件可以揭示改善创伤患者炎症控制的目标.
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