创伤患者的输血医学。
Transfusion medicine in trauma patients.
机构信息
University of Maryland School of Medicine, Baltimore, MD, USA.
出版信息
Expert Rev Hematol. 2008 Oct;1(1):99-109. doi: 10.1586/17474086.1.1.99.
Abstract
Injured patients stress the transfusion service with frequent demands for uncrossmatched red cells and plasma, occasional requirements for large amounts of blood products and the need for new and better blood products. Transfusion services stress trauma centers with demands for strict accountability for individual blood component units and adherence to indications in a clinical field where research has been difficult, and guidance opinion-based. New data suggest that the most severely injured patients arrive at the trauma center already coagulopathic and that these patients benefit from prompt, specific, corrective treatment. This research is clarifying trauma system requirements for new blood products and blood-product usage patterns, but the inability to obtain informed consent from severely injured patients remains an obstacle to further research.
摘要
受伤患者频繁要求输注未交叉配血的红细胞和血浆，偶尔需要大量血液制品，并且需要新的更好的血液制品，这给输血服务带来了压力。输血服务给创伤中心带来了压力，要求对每个血液成分单位进行严格的核算，并遵守在研究困难且以意见为导向的临床领域的适应症。新数据表明，最严重的受伤患者到达创伤中心时已经出现凝血功能障碍，这些患者从及时、具体、纠正性治疗中获益。这项研究阐明了创伤系统对新血液制品和血液制品使用模式的要求，但由于无法从重伤患者那里获得知情同意，进一步的研究仍然存在障碍。
相似文献
1
Transfusion medicine in trauma patients.创伤患者的输血医学。
Expert Rev Hematol. 2008 Oct;1(1):99-109. doi: 10.1586/17474086.1.1.99.
2
Transfusion medicine in trauma patients: an update.创伤患者的输血医学：更新。
Expert Rev Hematol. 2011 Oct;4(5):527-37. doi: 10.1586/ehm.11.49.
3
The Effect of Evolving Fluid Resuscitation on the Outcome of Severely Injured Patients: An 8-year Experience at a Tertiary Trauma Center.液体复苏方案的演变对重伤患者预后的影响：一家三级创伤中心的8年经验
Scand J Surg. 2016 Jun;105(2):109-16. doi: 10.1177/1457496915586650. Epub 2015 May 19.
4
Thrombelastography and transfusion patterns in severely injured pediatric trauma patients with blunt solid organ injuries.严重钝性实质性器官损伤的小儿创伤患者的血栓弹力描记术和输血模式。
J Trauma Acute Care Surg. 2022 Jan 1;92(1):152-158. doi: 10.1097/TA.0000000000003392.
5
Are we giving enough coagulation factors during major trauma resuscitation?在重大创伤复苏过程中，我们给予的凝血因子足够吗？
Am J Surg. 2005 Sep;190(3):479-84. doi: 10.1016/j.amjsurg.2005.03.034.
6
A randomized controlled pilot trial of modified whole blood versus component therapy in severely injured patients requiring large volume transfusions.一项改良全血与成分治疗在需要大量输血的严重创伤患者中的随机对照初步试验。
Ann Surg. 2013 Oct;258(4):527-32; discussion 532-3. doi: 10.1097/SLA.0b013e3182a4ffa0.
7
Initial safety and feasibility of cold-stored uncrossmatched whole blood transfusion in civilian trauma patients.civilian创伤患者中冷储存未交叉配血全血输注的初步安全性和可行性
J Trauma Acute Care Surg. 2016 Jul;81(1):21-6. doi: 10.1097/TA.0000000000001100.
8
Transfusion of modified whole blood versus blood components therapy in patients with severe trauma: Randomized controlled trial protocol (WEBSTER trial).严重创伤患者改良全血输注与血液成分治疗的比较：随机对照试验方案（WEBSTER试验）
Injury. 2025 May;56(5):112173. doi: 10.1016/j.injury.2025.112173. Epub 2025 Jan 23.
9
Experience of implementing a National pre-hospital Code Red bleeding protocol in Scotland.在苏格兰实施国家院前红色出血急救方案的经验。
Injury. 2017 Jan;48(1):41-46. doi: 10.1016/j.injury.2016.09.020. Epub 2016 Sep 11.
10
Resuscitation of trauma-induced coagulopathy.创伤性凝血病的复苏
Hematology Am Soc Hematol Educ Program. 2013;2013:664-7. doi: 10.1182/asheducation-2013.1.664.
引用本文的文献
1
Enhancing Trauma Care in Tertiary Hospitals: Addressing Gaps and Pathways to Improvement.加强三级医院的创伤护理：解决差距与改进途径
Emerg Med Int. 2025 Feb 17;2025:2780171. doi: 10.1155/emmi/2780171. eCollection 2025.
2
Safety of Uncrossmatched ABO-Compatible RBCs in Alloimmunized Patients with Bleeding: Data from Two Decades: Results of a Systematic Analysis in 6,109 Patients.未交叉配型的ABO相容红细胞在alloimmunized出血患者中的安全性：二十年的数据：对6109例患者的系统分析结果
Transfus Med Hemother. 2021 Dec 8;49(4):234-239. doi: 10.1159/000520649. eCollection 2022 Aug.
3
Potential Consequences of the Red Blood Cell Storage Lesion on Cardiac Electrophysiology.红细胞储存损伤对心脏电生理学的潜在影响。
J Am Heart Assoc. 2020 Nov 3;9(21):e017748. doi: 10.1161/JAHA.120.017748. Epub 2020 Oct 22.
4
Unmatched Type O RhD+ Red Blood Cells in Multiple Injured Patients.多发伤患者中不匹配的O型RhD阳性红细胞
Transfus Med Hemother. 2018 May;45(3):158-161. doi: 10.1159/000485388. Epub 2018 Mar 7.
5
Utilisation of Blood Components in Trauma Surgery: A Single-Centre, Retrospective Analysis before and after the Implementation of an Educative PBM Initiative.创伤手术中血液成分的使用：一项关于教育性循证医学管理举措实施前后的单中心回顾性分析
Transfus Med Hemother. 2015 Mar;42(2):83-9. doi: 10.1159/000377735. Epub 2015 Mar 12.
6
Clinical review: Canadian National Advisory Committee on Blood and Blood Products--Massive transfusion consensus conference 2011: report of the panel.临床综述：加拿大国家血液和血液制品顾问委员会——2011 年大量输血共识会议：专家组报告。
Crit Care. 2011;15(6):242. doi: 10.1186/cc10498. Epub 2011 Dec 8.
本文引用的文献
1
Increased plasma and platelet to red blood cell ratios improves outcome in 466 massively transfused civilian trauma patients.血浆与血小板与红细胞比值升高可改善466例大量输血的 civilian 创伤患者的预后。 （注：这里“civilian”结合语境推测可能是“平民”，但从医学专业角度看这个词在这个语境不是非常准确的医学术语表述，可能原文有误或有特定背景含义）
Ann Surg. 2008 Sep;248(3):447-58. doi: 10.1097/SLA.0b013e318185a9ad.
2
Giving plasma at a 1:1 ratio with red cells in resuscitation: who might benefit?在复苏过程中以1:1的比例输注血浆和红细胞：哪些人可能受益？
Transfusion. 2008 Aug;48(8):1763-5. doi: 10.1111/j.1537-2995.2008.01743.x. Epub 2008 May 14.
3
Damage control hematology: the impact of a trauma exsanguination protocol on survival and blood product utilization.损伤控制血液学：创伤性失血方案对生存率和血液制品使用的影响。
J Trauma. 2008 May;64(5):1177-82; discussion 1182-3. doi: 10.1097/TA.0b013e31816c5c80.
4
QuikClot use in trauma for hemorrhage control: case series of 103 documented uses.快速凝血剂在创伤中用于控制出血：103例有记录使用情况的病例系列
J Trauma. 2008 Apr;64(4):1093-9. doi: 10.1097/TA.0b013e31812f6dbc.
5
Transfusion-associated microchimerism in combat casualties.战斗伤员中的输血相关微嵌合体
J Trauma. 2008 Feb;64(2 Suppl):S92-7; discussion S97-8. doi: 10.1097/TA.0b013e318160a590.
6
Practical use of emergency tourniquets to stop bleeding in major limb trauma.紧急止血带在四肢严重创伤止血中的实际应用。
J Trauma. 2008 Feb;64(2 Suppl):S38-49; discussion S49-50. doi: 10.1097/TA.0b013e31816086b1.
7
An alternative hemostatic dressing: comparison of CELOX, HemCon, and QuikClot.一种替代性止血敷料：CELOX、HemCon和QuikClot的比较。
Acad Emerg Med. 2008 Jan;15(1):74-81. doi: 10.1111/j.1553-2712.2007.00009.x.
8
The TNF (-308A) polymorphism is associated with microchimerism in transfused trauma patients.肿瘤坏死因子（-308A）基因多态性与输血创伤患者的微嵌合体有关。
Blood. 2008 Apr 1;111(7):3880-3. doi: 10.1182/blood-2007-08-107144. Epub 2008 Jan 16.
9
The National Study on Costs and Outcomes of Trauma.全国创伤成本与结果研究
J Trauma. 2007 Dec;63(6 Suppl):S54-67; discussion S81-6. doi: 10.1097/TA.0b013e31815acb09.
10
The ratio of blood products transfused affects mortality in patients receiving massive transfusions at a combat support hospital.在一家战斗支援医院接受大量输血的患者中，所输注血液制品的比例会影响死亡率。
J Trauma. 2007 Oct;63(4):805-13. doi: 10.1097/TA.0b013e3181271ba3.
Zotero 插件