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通用新鲜冰冻血浆(Uniplas):心脏直视手术中的一种安全产品。

Universal fresh frozen plasma (Uniplas): a safe product in open-heart surgery.

作者信息

Tølløfsrud Stein, Noddeland Harald, Svennevig Jan Ludvig, Bentsen Gunnar, Mollnes Tom Eirik, Solheim Bjarte G

机构信息

Department of Anaesthesiology, Rikshospitalet University Hospital, Oslo, Norway.

出版信息

Intensive Care Med. 2003 Oct;29(10):1736-43. doi: 10.1007/s00134-003-1952-3. Epub 2003 Sep 4.

Abstract

OBJECTIVE

To test the tolerability and safety of the universal plasma Uniplas [solvent/detergent (SD)-treated plasma], infused regardless of the patient's blood group.

DESIGN

Prospective, parallel group, controlled and observer-blinded study, randomized with respect to patients requiring plasma transfusion.

SETTING

Cardiothoracic operating room and ICU in a university hospital.

PATIENTS

Eighty-four patients undergoing open-heart surgery comparing three parallel treatment groups and one control group.

INTERVENTIONS

The Uniplas treatment group was subdivided into patients with blood group A, B or AB, and group O. The treatment group receiving Octaplas of type AB, was not subdivided. Patients who did not require any plasma transfusion served as control.

MEASUREMENTS

Complement activation (C3bc, TCC), direct antiglobulin test (DAT) and other immunohaematological tests, tests for haemolysis, and relevant clinical observations during treatment phase. Blood samples were collected again after 6 months for evaluation of viral safety.

RESULTS

Of the 84 patients, 29 served as control group. Uniplas was transfused in 36 of the patients (1-23 units). Octaplas was transfused in 19 patients (1-11 units). During the study no clinical adverse events related to plasma transfusion were observed. The degree of complement activation C3bc and TCC, a recommended test for biocompatibility, did not show any increased activation after Uniplas or Octaplas transfusion. No haemolytic reactions, positive DAT-tests or viral transmissions were observed after Uniplas transfusion.

CONCLUSION

In open-heart surgery, Uniplas, which can be transfused regardless of a patient's blood group, was well-tolerated and gave no adverse drug reactions.

摘要

目的

测试通用血浆Uniplas[溶剂/去污剂(SD)处理的血浆]的耐受性和安全性,无论患者血型如何均可输注。

设计

前瞻性、平行组、对照且观察者盲法研究,对需要输血的患者进行随机分组。

地点

大学医院的心胸手术室和重症监护病房。

患者

84例接受心脏直视手术的患者,分为三个平行治疗组和一个对照组。

干预措施

Uniplas治疗组再细分为A型、B型或AB型血患者以及O型血患者。接受AB型Octaplas的治疗组未细分。不需要任何血浆输注的患者作为对照。

测量指标

补体激活(C3bc、TCC)、直接抗球蛋白试验(DAT)和其他免疫血液学检测、溶血检测以及治疗阶段的相关临床观察。6个月后再次采集血样以评估病毒安全性。

结果

84例患者中,29例作为对照组。36例患者输注了Uniplas(1 - 23单位)。19例患者输注了Octaplas(1 - 11单位)。研究期间未观察到与血浆输注相关的临床不良事件。补体激活程度C3bc和TCC(一种推荐的生物相容性检测)在输注Uniplas或Octaplas后未显示激活增加。输注Uniplas后未观察到溶血反应、DAT试验阳性或病毒传播。

结论

在心脏直视手术中,可不分患者血型进行输注的Uniplas耐受性良好,未出现药物不良反应。

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