Department of Surgery, Division of Acute Care Surgery, University of Michigan, 1500 E Medical Center Drive, Ann Arbor, MI 48109, USA.
Crit Care. 2011;15(2):152. doi: 10.1186/cc10124. Epub 2011 Apr 18.
Marked variability in transfusion practice exists in cardiac surgical patients, with consumption of approximately 20% of the worldwide allogeneic blood supply. Observational studies have reported an association between red blood cell transfusion and adverse outcome, including pulmonary complications, in cardiac surgery. Tuinman and colleagues report that transfusions were associated with activation of pulmonary inflammation and coagulation by measurement of biomarkers in bronchoalveolar lavage fluid, and suggest that transfusion may be a mediator of acute lung injury. This study provides interesting preliminary data, but is limited by multiple confounding variables (plasma transfusion, use of anticoagulants and heparin antagonists) and the small sample size. A large multicenter, prospective, randomized clinical trial regarding the safety (inclusive of pulmonary complications) and efficacy of red blood cell transfusion in cardiac surgery is needed.
在心脏外科患者中，输血实践存在明显的差异，大约消耗了全球 20%的异体血供应。观察性研究报告称，输血与心脏手术后的不良后果（包括肺部并发症）之间存在关联。Tuinman 及其同事报告说，通过测量支气管肺泡灌洗液中的生物标志物，输血与肺部炎症和凝血的激活有关，并表明输血可能是急性肺损伤的介质。这项研究提供了有趣的初步数据，但受到多个混杂变量（血浆输血、抗凝剂和肝素拮抗剂的使用）和样本量小的限制。需要进行一项关于心脏手术中红细胞输血安全性（包括肺部并发症）和疗效的大型多中心前瞻性随机临床试验。
