在创伤性大规模输血协议期间需要积极纠正低血症
Alexander J Urevick1, R Chace Hicks1, Kevin Harrell1
1Department of Surgery, University of Tennessee, College of Medicine at Chattanooga, Chattanooga, TN, USA.
The American surgeon
|September 24, 2025
概括
在创伤患者接受大规模输血方案 (MTP) 后,低血或低血与较高的死亡率有关. 早期的校正可能会改善这些关键患者的生存率.
科学领域:
- 创伤重症监护中心的重症监护中心.
- 输血药物 输血药物 输血药物
- 临界护理脏病学重症监护
背景情况:
- 低血是创伤患者大规模输血协议 (MTP) 后的常见并发症.
- 低血症严重程度对MTP患者死亡风险的直接生理影响需要进一步调查.
- 了解水平动态对于管理MTP相关并发症至关重要.
研究的目的:
- 调查MTP中创伤患者的水平和死亡率之间的关联.
- 为了测试缺血症增加MTP患者死亡风险的假设.
- 评估的时间和水平对患者的治疗结果的影响.
主要方法:
- 在2018年至2023年期间接受MTP (在24小时内≥10单位血液) 的153名创伤患者的回顾性评估.
- 在入院和MTP后测量的电离 (iCal) 含量;每四个红细胞单位服用一次.
- 后勤回归分析用于确定6小时和24小时死亡率的风险因素.
主要成果:
- 整体6小时死亡率为26%,24小时死亡率为34%.
- 在6小时内死亡的患者在MTP后iCal水平显著降低 (0.84vs1.27mmol/L),并且获得了更多的 (6gvs4g).
- 较高的MTP后iCal与死亡率的降低有很强的关联 (OR0.013),在多变量分析中仍然显著.
结论:
- 在创伤患者中,MTP后的低血症与短期死亡率的增加显著相关.
- 积极和早期纠正低血症可能是减少MTP患者死亡率的关键干预措施.
- 对电离水平的监测和管理是MTP护理的重要组成部分.
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