红细胞输血实践在体外膜氧化:一个单中心研究
Shailesh Balasubramanian1, Mahmoud Alwakeel2, Divyajot Sadana3
1The Division of Pulmonary and Critical Care Medicine, Clinical Immunology, and Allergy, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
Transfusion medicine (Oxford, England)
|July 4, 2025
概括
在体外膜氧化 (ECMO) 治疗的患者中,维持血红蛋白水平高于8g/dL可能会缩短治疗时间. 这项研究发现较低的血红蛋白水平与更长的ECMO支持有关.
科学领域:
- 关键护理医学 关键护理医学
- 血液学 血液学 血液学
- 心血管外科心血管外科
背景情况:
- 身体外膜氧化 (ECMO) 的使用在重症监护中正在增加.
- 在ECMO期间最佳的血红蛋白 (Hgb) 水平受到争论,指南建议更高的水平,但一些证据表明潜在的危害.
- 本研究调查了Hgb水平对ECMO结果的影响.
研究的目的:
- 评估输血实践及其对接受ECMO的患者发病率和死亡率的影响.
- 确定与减少ECMO持续时间和住院死亡率相关的最佳血红蛋白 (Hgb) 水平.
主要方法:
- 从2016年1月到2018年12月,对成年ECMO患者进行了回顾性队列研究.
- 对血红蛋白水平 (7-7.9 g/dL, 8-8.9 g/dL, 9-9.9 g/dL, ≥10 g/dL) 的分析.
- 用多变量和考克斯比例回归分析来评估结果.
主要成果:
- 与Hgb≥10g/dL患者相比,Hgb7-7.9g/dL患者的ECMO持续时间明显更长 (平均17.5天与未指定的).
- 在Hgb水平之间没有观察到显著的死亡率差异.
- 静脉 (VA) ECMO与静脉 (VV) ECMO (aHR 2.33) 相比,与更高的死亡风险有关.
- 新鲜冷血 (FFP) 的使用减少了ECMO持续时间和死亡风险.
结论:
- 目标血红蛋白水平大于8g/dL可能会减少ECMO持续时间.
- 在ECMO期间对输血策略的进一步研究是有必要的.
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