心脏手术后急性常态血稀释:随机对照试验的元分析
Alessandro Pruna1, Alessandro Oriani1, Fabrizio Monaco2
1Department of Anaesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy.
British journal of anaesthesia
|January 20, 2026
概括
急性正常血流血稀释 (ANH) 并没有降低心脏手术患者的全方位包装红细胞输血总量. 然而,尽管有试验的局限性,但ANH确实在手术后48小时内减少了输血.
科学领域:
- 心脏病学 心脏病学
- 输血医学 输血医学
- 手术创新 在外科创新.
背景情况:
- 急性常态血稀释 (ANH) 是一种常见的策略,用于减少心脏手术后的红细胞输血.
- 对ANH对整体住院输血率的影响尚不清楚.
研究的目的:
- 评估ANH是否会降低心脏手术患者在术后住院期间接受全源PRBC输血的比例.
- 评估二次结果,包括早期术后输血率,手术修复和死亡率.
主要方法:
- 随机对照试验的元分析,涉及接受心脏手术的成年患者.
- 主要结局:在术后接受异构pRBC输血的患者比例 (不包括48小时观察的试验).
- 二次结局:在48小时内输血,手术修复和全因死亡率.
主要成果:
- ANH并没有显著降低接受全方位pRBC输血的患者的总体比例 (40%与43%相比,RR 0.94).
- 在手术后的前48小时内观察到输血的显著减少 (RR 0.64).
- 在手术修复率或所有原因死亡率方面没有发现显著差异.
结论:
- 在心脏外科手术患者住院期间,ANH并没有降低异性pRBC输血的整体率.
- 这些发现应该与包括在内的试验中发现的中期偏差风险一起考虑.
- 虽然ANH可能会减少早期的术后输血,但它对整体输血率的影响需要进一步研究.
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