旋转血小板造影仪有助于减少在肝功能衰竭患者进行血交换的患者中,用于移植插入的预防性血液产品的使用
Vijesh V S1, Santhosh E Kumar2, Tulasi Geevar3
1Department of Gastroenterology, Christian Medical College, Vellore, 632 004, India.
概括
旋转血栓显著减小 (ROTEM) 引导输血显著减少了在急性肝衰竭 (ALF) 和急性至慢性肝衰竭 (ACLF) 进行血交换 (PLEX) 的患者的预防性血液产品的使用. 这一策略提高了输血效率,但没有增加出血事件.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 输血医学 输血医学
- 关键的护理关键的护理
背景情况:
- 血交换 (PLEX) 是一种治疗肝衰竭患者的治疗方法.
- 在急性肝衰竭 (ALF) 和急性至慢性肝衰竭 (ACLF) 中,在PLEX端口放置之前,对手术前输血血产品没有确定的指导方针.
研究的目的:
- 为了比较ALF和ACLF患者之间的预防性血液产品使用,他们接受了PLEX与旋转血栓等位测量 (ROTEM) 指导与单独的常规凝血测试 (CCT).
- 评估港口出血事件和ROTEM参数与CCT之间的相关性.
主要方法:
- 在2016年10月至2022年2月期间接受PLEX的ALF和ACLF患者的回顾性分析.
- 倾向性得分匹配 (PSM) 用于比较用于输血策略的ROTEM (RG) 与CCT (CG) 管理的患者.
- 分析了ROTEM参数和CCT的相关性.
主要成果:
- 在PSM后的ALF和ACLF患者中,在ROTEM组 (RG) 与常规凝血组 (CG) 相比,预防性血液制品的使用明显较低.
- 当地港口出血事件很少发生,并且在各组之间相似.
- ROTEM参数与CCT的相关性较弱至较强,特别是在最大凝块坚度 (MCF) 和纤维素/血小板之间.
结论:
- 基于ROTEM的输血策略有效地减少了ALF和ACLF患者在PLEX端口插入之前的预防性血液产品输血.
- 这种方法提供了一个更有针对性的输血策略,有可能优化资源利用.
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