医疗重症监护室的限制性输血实践:来自北土耳其的现实生活数据
1Department of Hematology, Medicana International Samsun Hospital, Şht. Mesut Birinci Cd. No:85, Samsun, Yenimahalle 55080 Turkey.
概括
在ICU中的限制性输血政策,血红蛋白值<7g/dL,并没有增加患者的死亡率. 虽然输血患者的结果较差,但输血本身并不是原因. 这项研究支持限制性输血实践.
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
- 输血医学 输血医学
背景情况:
- 贫血在重症监护室 (ICU) 患者中很普遍,但红细胞输血对死亡率的影响尚不清楚.
- 之前的研究并没有明确地确定输血和ICU环境中的患者结果之间的因果关系.
研究的目的:
- 调查限制性红细胞输血策略对ICU内患者结果的影响.
- 确定遵守严格的输血政策是否会影响重症患者的死亡率.
主要方法:
- 分析了2018年8月至2019年8月期间住院的143名ICU患者的队列.
- 根据在限制性政策下接受输血 (血红蛋白值<7 g/dL) 患者被分类.
- 使用分层后勤回归来确定输血和死亡率的预测因素.
主要成果:
- 43%的患者接受了平均3个单位的红细胞.
- 输血患者年龄较大,有更长的ICU和侵入性机械通风持续时间,以及更高的未调整死亡率.
- 在调整了混因素后,输血与死亡率的增加无关;血管压缩剂使用和侵入性机械通风预测死亡率.
结论:
- 在ICU中限制性输血政策 (Hb <7 g/dL) 与患者死亡率的增加无关.
- 虽然需要输血的患者更生病,但输血本身并没有独立地增加死亡风险.
- 实施限制性输血策略和减少ICU停留时间可能会改善患者的治疗结果.
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