Yogore Mariano G, Boral Leonard, Kowal-Vern Areta, Patel Harita, Brown Susan, Latenser Barbara A
Blood Bank, Department of Pathology, Chicago, Illinois, USA.
J Burn Care Res. 2006 Nov-Dec;27(6):835-41. doi: 10.1097/01.BCR.0000245418.73538.25.
Burn patients may need transfusions, especially during surgery. The purpose of the study was to determine blood bank services utilization at an urban burn center. This was a retrospective review (March 1999 to May 2004) of burn patient data on blood utilization. There were 1615 admissions; 800 (49.5%) of the patients had a type and screen (T and S); 180 of 1615 (11%) were transfused with 1691 red blood cell (RBC) units; 616 units of fresh- frozen plasma (FFP), 399 units of pooled platelets, and 38 units of apheresis platelets. Of the 180 transfused patients, 140 (79%) received RBCs, 11 (6%) received RBCs plus FFP, 23 (13%) received RBCs plus FFP plus platelets, and 3 (2%) each received RBCs plus platelets and FFP. Overall, 3393 red cell units were cross-matched, and 1691 units were transfused for a cross-match/transfused unit (C/T) ratio of 2.01. Seventy-three (5.7%) of 1282 of patients with 0% to 10% TBSA required transfusions; 42 (21%) of 193 with 11% to 20% TBSA; 24 (39%) of 61 with 21% to 30% TBSA; and 62% of patients with 31% or greater TBSA required transfusion (P = .001). As %TBSA increased, more of the cross-matched units were transfused: 37% in the 0% to 10% TBSA to 59% in the 30% or greater TBSA burn. The C/T ratio in the 0% to 10% TBSA was 2.69; only 18% of patients with a T&S received blood. Although most patients who underwent transfusion were in the less than 30% TBSA group, more of the red cell units were used in patients with a 30% or greater TBSA burn. Elimination of admission T&S and cross matches in burn patients with less than 20% TBSA may improve the C/T ratio in this cohort.
烧伤患者可能需要输血，尤其是在手术期间。本研究的目的是确定一家城市烧伤中心的血库服务利用情况。这是一项对烧伤患者血液利用数据的回顾性研究（1999年3月至2004年5月）。共有1615例入院患者；其中800例（49.5%）进行了血型鉴定和筛查（T&S）；1615例中有180例（11%）输注了1691个红细胞（RBC）单位；616单位新鲜冰冻血浆（FFP），399单位混合血小板，以及38单位单采血小板。在180例接受输血的患者中，140例（79%）接受了红细胞输注，11例（6%）接受了红细胞加FFP输注，23例（13%）接受了红细胞加FFP加血小板输注，3例（2%）分别接受了红细胞加血小板和FFP输注。总体而言，共交叉配血3393个红细胞单位，输注1691个单位，交叉配血/输注单位（C/T）比为2.01。1282例烧伤面积为0%至10%的患者中有73例（5.7%）需要输血；193例烧伤面积为11%至20%的患者中有42例（21%）；61例烧伤面积为21%至30%的患者中有24例（39%）；烧伤面积为31%或更大的患者中有62%需要输血（P = .001）。随着烧伤面积百分比（%TBSA）的增加，交叉配血后输注的单位更多：烧伤面积0%至10%的患者中为37%，烧伤面积30%或更大的患者中为59%。烧伤面积0%至10%患者的C/T比为2.69；进行T&S检测的患者中只有18%接受了输血。虽然大多数接受输血的患者在烧伤面积小于30%的组中，但更多的红细胞单位用于烧伤面积为30%或更大的患者。对于烧伤面积小于20%的烧伤患者，取消入院时的T&S检测和交叉配血可能会改善该队列的C/T比。
