一个改进项目,标准化婴儿低预防性血小板输血剂量
Kristen Coletti1,2, Jennifer A Hershey3, Matthew Devine4
1Division of Neonatology, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
概括
在新生儿中将血小板输血标准化为10mL/kg,减少了暴露和节约资源. 这种实践改变提高了新生儿重症监护室 (NICU) 的安全性和效率.
科学领域:
- 新生儿医学 新生儿医学
- 血液学 血液学 血液学
- 儿科重症监护 儿科重症监护
背景情况:
- 血小板输血对于早产婴儿来说很常见,但目前的做法可能是有害的.
- 随机试验表明与现有的输血协议相关的不良影响.
- 经常使用高输血量 (15-20毫升/公斤).
研究的目的:
- 为了减少新生儿的血小板暴露.
- 实施标准化10毫升/千克血小板输血对非出血的血小板缺血的婴儿.
- 改善IV级新生儿重症监护室 (NICU) 的血小板输血实践.
主要方法:
- 制定了基于证据的血小板剂量指南.
- 通过三个计划-做-研究-行动周期实施变化.
- 专注于教育,强化和电子临床决策支持.
主要成果:
- 在10毫升/公斤的输血中达到100%的坚持率,高于17.6%的水平.
- 没有观察到严重出血或重复输血率的增加.
- 显著减少每月输血的血小板体积 (2269±334毫升至857±181毫升).
- 其结果是每月节省了2746美元至4942.42美元的成本.
结论:
- 成功改善了新生儿的血小板输血实践.
- 对其他机构采取指导方针的可行性已被证明.
- 促进了有限的血小板资源的保护和成本节省.
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