Johansson P I, Hansen M B, Sørensen H
Department of Clinical Immunology, University Hospital of Copenhagen, Copenhagen, Denmark.
Vox Sang. 2005 Aug;89(2):92-6. doi: 10.1111/j.1423-0410.2005.00668.x.
We identified some fatal cases where massively bleeding patients received inadequate transfusion therapy. The aim of this study was to review and evaluate the transfusion practice in acutely multitransfused patients.
Patients receiving > 10 units of red blood cells (RBC) within 24 h of admission and 30 blood components within 7 days of admission were reviewed.
Thirty-nine patients were identified, 13 of whom were inadequately transfused (IT) and had a higher mortality (12/13) than adequately transfused (AT) patients 13/26 (P = 0.013). Ten of 13 IT patients developed a microvascular bleed compared to four of 26 in the AT group (P = 0.001) and had a lower platelet count upon arrival at the intensive care unit (40 x 10(9)/l vs. 80 x 10(9)/l, P = 0.024).
An early balanced transfusion therapy is vital in massively bleeding patients, and a pro-active approach from the blood bank is warranted. We have introduced an acute transfusion package (ATP) consisting of 5 RBC, 5 FFP and 2 PC units, indicated in massively bleeding patients, securing a balanced transfusion therapy.
我们发现了一些大量出血患者接受输血治疗不足的致命病例。本研究的目的是回顾和评估急性多次输血患者的输血实践。
对入院24小时内接受超过10单位红细胞（RBC）且入院7天内接受30种血液成分的患者进行回顾。
共确定39例患者，其中13例输血不足（IT），其死亡率（12/13）高于输血充足（AT）的患者13/26（P = 0.013）。13例IT患者中有10例发生微血管出血，而AT组26例中有4例（P = 0.001），且入住重症监护病房时血小板计数较低（40×10⁹/L对80×10⁹/L，P = 0.024）。
早期平衡输血治疗对大量出血患者至关重要，血库应采取积极主动的方法。我们推出了一种急性输血套餐（ATP），由5单位RBC、5单位新鲜冰冻血浆（FFP）和2单位血小板（PC）组成，适用于大量出血患者，确保平衡输血治疗。
