极低出生体重婴儿红细胞和血小板输血门的时间趋势
Ravi M Patel1, Jeanne E Hendrickson2, Rebecca Birch3
1Department of Pediatrics, Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, GA.
The Journal of pediatrics
|August 31, 2025
概括
极低出生体重 (ELBW) 婴儿的血液值显示红细胞输血水平下降,但血小板输血水平稳定. 这表明在临床实践中采用了新的输血证据.
科学领域:
- 新生儿医学
- 儿童血液学
- 临床输血实践
背景情况:
- 随机试验的证据为极低出生体重 (ELBW) 的婴儿提供了新的输血指南.
- 这种证据对临床实践对输血值的影响尚未完全阐明.
- 了解输血实践的时间趋势对于优化脆弱新生儿群体的护理至关重要.
研究的目的:
- 评估红细胞和血小板输血的血液学值的变化.
- 确定这些值是否随着时间的推移而演变,在关键的随机试验证据公布后.
- 调查输血门的趋势是否因出生后的年龄而异.
主要方法:
- 分析了涉及981名幼儿的REDS-IV-P研究数据 (2019年4月至2023年12月).
- 输血前血红蛋白和血小板数量在输血后24小时内进行比较,分年分析.
- 线性混合模型用于识别随时间推移的趋势和产后周的相互作用.
主要成果:
- 在研究期间,输血前血红蛋白值显著下降 (P< 0. 0001),从出生后第三周开始观察到最明显的下降.
- 随着时间的推移,血小板数值没有显著变化 (P=0. 24).
- 虽然在统计上没有显著性,但在出生后的第一周前血小板数量较低 (P< 0. 001).
结论:
- 在2019-2023年美国中心观察到血红蛋白临界值下降,但血小板临界值没有下降.
- 结果表明,最近的红细胞和血小板输血试验的证据在ELBW婴儿的临床实践中存在差异.
- 可能需要进一步的研究来了解这种不同采用的原因及其临床影响.
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