心脏手术后输血和急性损伤:一项回顾性观察性研究
Yuliya Boyko1,2, Sebastian B Rasmussen3, Justyna Bartoszko4,5
1Department of Anesthesiology and Intensive Care, Odense University Hospital, J.B. Winsløwsvej 4, 5000, Odense C, Denmark. yuliya.boyko@rsyd.dk.
概括
心脏手术后输血红细胞与急性损伤 (AKI) 有关. 输血红细胞数量的增加增加了AKI的风险和严重程度,证实了先前的发现.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 心脏病学 心脏病学
- 输血医学 输血医学
背景情况:
- 心脏手术相关的急性损伤 (AKI) 是一个显著的并发症.
- 术后红细胞 (RBC) 输血已被确定为AKI的潜在可修改风险因素.
- 以前的研究表明,输血的红细胞单位和AKI发生/严重程度之间存在剂量依赖的关系.
研究的目的:
- 在更大的患者队列中对外验证术后红细胞输血和AKI之间的关联.
- 确认红细胞输血和心脏手术后的AKI之间的剂量依赖关系.
主要方法:
- 对接受非突发性动心脏手术的成年患者进行了回顾性观察性研究.
- 2016年至2021年期间从多伦多综合医院收集的数据.
- 使用病AKI分类:改善全球结果 (KDIGO) 标准;通过逆概率加权后勤回归进行分析.
主要成果:
- 在5204名患者中,798名 (15.3%) 患有AKI.
- 红细胞输血与AKI显著相关,风险随着输血量增加而增加 (>2单位与第一阶段AKI的概率增加12%和2-3阶段AKI的概率增加9%相关).
- 患有AKI的患者年龄较大,手术前血红蛋白水平较低,估计膜过率较低,心肺绕道术持续时间较长.
结论:
- 这项研究证实了红细胞输血和心脏外科手术中的术后AKI之间的关联.
- 在输血超过两个红细胞单位时,AKI的风险显著增加.
- 进一步的前性研究是有必要的,以优化输血策略和探索替代方案.
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