Despotis George John, Zhang Lini, Lublin Douglas M
Department of Anesthesiology, Box 8054, Washington University School of Medicine, 660 South Euclid Avenue, St. Louis, MO 63110, USA.
Hematol Oncol Clin North Am. 2007 Feb;21(1):147-61. doi: 10.1016/j.hoc.2006.11.002.
Despite improvements in blood screening and administration techniques, serious adverse events related to transfusion continue to occur, albeit at a much lower incidence. In addition to the development and implementation of new screening and blood purification/modification techniques and implementation of an optimal blood management program, the incidence and consequences of transfusion reactions can be reduced by a basic understanding of transfusion-related complications. Although acute hemolytic transfusion reactions, transfusion-associated anaphylaxis and sepsis, and transfusion-associated acute lung injury occur infrequently, diligence in administration of blood and monitoring for development of respective signs/symptoms can minimize the severity of these potentially life-threatening complications. In addition, emerging blood-banking techniques such as psoralen-UV inactivation of pathogens and use of patient identification systems may attenuate the incidence of adverse events related to transfusion. With respect to optimizing blood management by means of an effective blood management program involving pharmacologic and nonpharmacologic strategies, the ability to reduce use of blood products and to decrease operative time or re-exploration rates has important implications for disease prevention, blood inventory and costs, and overall health care costs.
尽管血液筛查和输注技术有所改进，但与输血相关的严重不良事件仍在发生，尽管发生率已大幅降低。除了开发和实施新的筛查及血液净化/改性技术以及实施最佳血液管理计划外，通过对输血相关并发症的基本了解，可降低输血反应的发生率及其后果。虽然急性溶血性输血反应、输血相关过敏反应和败血症以及输血相关急性肺损伤很少发生，但在输血过程中保持谨慎并监测各自体征/症状的发展，可将这些潜在危及生命的并发症的严重程度降至最低。此外，诸如补骨脂素-紫外线病原体灭活和使用患者识别系统等新兴血库技术，可能会降低与输血相关的不良事件的发生率。关于通过涉及药理学和非药理学策略的有效血液管理计划来优化血液管理，减少血液制品使用量以及缩短手术时间或再次探查率的能力对于疾病预防、血液库存和成本以及总体医疗保健成本具有重要意义。
