在紧急医疗服务的输血中,特征,区域评估和D-抗原
Carlo L Rosen1, Sarah Alice Thomas2, Michael P McCartin3
1Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
JAMA network open
|July 31, 2025
概括
医院前输血 (PHT) 实践在美国各地各不相同,全血 (WB) 的使用越来越多. 孕期女性越来越多地接受D阳性血液,突出了对标准化PHT协议的需求.
科学领域:
- 紧急医疗 紧急医疗
- 血液学 血液学 血液学
- 公共卫生 公共卫生
背景情况:
- 紧急医疗服务 (EMS) 的医院前输血 (PHT) 在平民环境中越来越常见.
- 美国关于PHT的实践和数据显示出显著的变化.
- 关键的关注领域包括使用的血液制品,孕期女性的D阳性血液暴露,以及运输时间.
研究的目的:
- 评估PHT实践的全国趋势.
- 为了确定PHT的区域差异.
- 为了评估潜在的风险,特别是对孕期女性的D阳性血液的注射.
主要方法:
- 一项大型队列研究 (CREDIT-EMS) 分析了来自美国48个州的数据 (2020年1月 - 2024年10月).
- 该研究包括接受PHT的所有年龄段的创伤和非创伤患者.
- 分析的数据包括患者人口统计,血液制品特征 (类型和血型),以及运输时间.
主要成果:
- 10444名患者接受了18177个单位的血液制品.
- 全血 (WB) 的使用量从2020年的10.0%显著增加到2024年的30.8%.
- 15.2%的患者是孕期女性,D阳性PHT显著增加 (2020年为43.2%,到2024年为74.9%).
- 短的医院前运输时间 (<20分钟) 是罕见的 (2.5%).
结论:
- 美国民用PHT实践表现出显著的地理和时间变化.
- 越来越多的WB采用和D阳性PHT在生育年龄的女性中的上升率具有关键的意义.
- 这些发现强调了需要标准化的PHT协议和进一步的风险效益分析.
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