危重症患者贫血与输血实践：一项前瞻性队列研究。

Anemia and blood transfusion practices in the critically ill: a prospective cohort review.

机构信息

Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada.

出版信息

Heart Lung. 2010 May-Jun;39(3):217-25. doi: 10.1016/j.hrtlng.2009.07.002. Epub 2009 Sep 12.

DOI:10.1016/j.hrtlng.2009.07.002

PMID:20457342

Abstract

BACKGROUND

Nearly 75% of critically ill patients develop anemia in the intensive care unit (ICU). Anemia can be treated with red blood cell (RBC) transfusions, although evidence suggests that lower hemoglobin levels are tolerated in the critically ill. Despite such recommendations, variation exists in clinical practice.

METHODS

A prospective cohort was assessed for anemia and RBC transfusion practices in 100 consecutive adults admitted to our General Systems ICU.

RESULTS

The prevalence of anemia in this cohort was 98%. Mean blood loss via phlebotomy was 25+/-10.3 mL per patient per day. The RBC transfusion rate for the ICU stay was 40%, increasing to 70% in patients whose ICU stay was >7 days. The mean pretransfusion level of hemoglobin was 7.35+/-0.47 mg/dL for the total cohort, and 8.2+/-0.65 mg/dL for those with a history of cardiovascular disease.

CONCLUSION

Anemia was common in this critically ill cohort, with hemoglobin levels continuing to drop with ICU stay. Pretransfusion hemoglobin levels were lower than reported by others, yet the RBC transfusion rate was comparable. There was no association between anemia and phlebotomy practices in our ICU.

摘要

背景

近 75%的重症监护病房（ICU）患者会出现贫血。贫血可以通过输注红细胞（RBC）来治疗，但有证据表明，危重患者可以耐受较低的血红蛋白水平。尽管有这些建议，但临床实践中仍存在差异。

方法

对 100 例连续入住我院综合系统 ICU 的成年患者进行前瞻性队列评估，以评估贫血和 RBC 输血情况。

结果

该队列的贫血患病率为 98%。平均每天每位患者通过采血损失的血液量为 25+/-10.3 毫升。ICU 期间的 RBC 输血率为 40%，在 ICU 入住时间>7 天的患者中增加到 70%。总队列的平均输血前血红蛋白水平为 7.35+/-0.47mg/dL，有心血管疾病史的患者为 8.2+/-0.65mg/dL。