Department of Transfusion Medicine, Warren G. Magnuson Clinical Center, National Institutes of Health, Bethesda, Maryland, USA.
Vox Sang. 2010 Jan;98(1):2-11. doi: 10.1111/j.1423-0410.2009.01223.x. Epub 2009 Aug 4.
Therapeutic red blood cell (RBC) transfusion is widely utilized in the management of anaemia. Critically ill intensive care unit (ICU) patients in particular, as well as medical and haematology-oncology patients, are among the largest groups of users of RBC products. While anaemia is common in these patients, its treatment and management, including appropriate thresholds for RBC transfusion, remain controversial. We review here the function of RBCs in oxygen transport and physiology, with a view to their role in supporting and maintaining systemic tissue oxygenation. Adaptive and physiological compensatory mechanisms in the setting of anaemia are discussed, along with the limits of compensation. Finally, data from clinical studies will be examined in search of evidence for, or against, a clinically relevant transfusion trigger.
治疗性红细胞（RBC）输血在贫血的治疗中被广泛应用。危重症加强护理病房（ICU）患者，特别是血液科肿瘤患者，是 RBC 制品的最大使用者群体之一。尽管这些患者中贫血很常见，但关于其治疗和管理，包括 RBC 输血的适当阈值，仍存在争议。本文综述 RBC 在氧输送和生理学中的功能，以探讨其在支持和维持全身组织氧合中的作用。讨论了在贫血情况下适应性和生理性代偿机制，以及代偿的极限。最后，将检查临床研究中的数据，以寻找支持或反对临床相关输血触发因素的证据。
