在重症监护室的败血病患者的全球输血实践:来自InPUT研究子分析的见解
Vincent C Kurucz1, Andrew W J Flint2,3, Alexis Poole3
1Department of Intensive Care, Amsterdam University Medical Centers, Amsterdam, The Netherlands.
Transfusion
|October 22, 2025
概括
患有败血症的重症监护病房 (ICU) 患者的输血实践显示,一致使用限制性红细胞 (RBC) 值. 然而,在血小板和血输血中存在显著的变异性,强调需要更新败血症输血指南.
科学领域:
- 关键护理医学 关键护理医学
- 血液学 血液学 血液学
- 传染性疾病 传染性疾病
背景情况:
- 在重症监护室 (ICU) 治疗败血症需要做出复杂的输血决策.
- 目前红细胞 (RBC) 输血在败血症的指导方针相对确立,但血小板和血输血的指示仍然不清楚.
- 输血实践的变化可能会影响患者的治疗结果.
研究的目的:
- 分析目前的血液产品输血实践在重症监护室 (ICU) 患有败血症的患者.
- 在这个人群中调查用于红细胞 (RBC),血小板和血输血的特定触发因素和值.
- 确定可变性领域和指导方针改进的潜在目标.
主要方法:
- 对国际重症监护病房输血实践点患病率研究进行了败血症特定的子分析.
- 这项前性,多中心的观察性研究包括在一段时间内接受成人ICU治疗的患者.
- 收集的数据包括人口统计数据,每日实验室值和符合败血症标准的患者的输血触发因素.
主要成果:
- 在799名败血症患者中,40%接受了血液成分.
- 红细胞 (RBC) 输血 (34%) 主要用于贫血/血液动力学不稳定,平均血红蛋白为7.5g/dL,表明限制性做法.
- 血小板输血 (10%) 和血输血 (14%) 在指示和值方面表现出相当大的差异.
结论:
- 败血症患者的国际输血实践表明,他们遵守了严格的红细胞值.
- 血小板和血在败血症患者的利用中存在显著的异质性.
- 需要进一步的临床试验,以建立基于证据的指导方针,用于血小板和血输血在败血症.
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