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术前输血,术后血红蛋白和新生儿的临床结果:来自大型四级医院的回顾性观察研究

Susan M Goobie¹, Qinglan Huang², Samir Seshadri¹

¹From the Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts.

Anesthesia and analgesia

|November 11, 2025

概括

在非心脏手术期间接受红细胞 (RBC) 输血的新生儿中,超过一半的新生儿过度输血. 输血量超过25毫升/千克与死亡率的增加有关,这突显了对新生儿的保守输血指导方针的需要.

科学领域:

新生儿手术新生儿手术
输血医学输血医学
儿科重症监护儿科重症监护

背景情况:

新生儿是手术期间输血最多的患者群体.
目前的指导方针建议限制性红细胞 (RBC) 输血策略.
输血门因妊娠年龄和呼吸系统支持等临床因素而异.

研究的目的:

评估接受非心脏手术的新生儿的红细胞输血实践.
为了确定红细胞过度输血的发生率 (血红蛋白[Hb]≥12.0 g/dL).
探索输血量与以患者为中心的结果之间的关系.

主要方法:

对1305名接受非心脏手术的新生儿进行了回顾性观察性研究.
过度输血被定义为术后的Hb≥12.0 g/dL.
用后勤回归分析人口统计,输血暴露和临床结果的分析.

主要成果:

术后红细胞输血率为22.8%.
过度输血发生在51.1%的输血新生儿中.
输血量>25mL/kg与30天和1年死亡率的增加有关.

结论:

在这个队列中,超过50%的被输血的新生儿被过度输血.
更高的输血量 (>25毫升/公斤) 可能与不良结果有关.
需要基于证据的患者血液管理策略,以优化新生儿输血门.

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