Edward D Viner Intensive Care Unit, Cooper University Hospital, Camden, NJ 08103, USA.
J Crit Care. 2012 Dec;27(6):737.e1-9. doi: 10.1016/j.jcrc.2012.05.007. Epub 2012 Jul 2.
Packed red blood cell (PRBC) transfusion is common in patients undergoing cardiac surgery. Evidence has accumulated demonstrating that such patients can tolerate relatively low hemoglobins, and an extensive body of literature has developed demonstrating that patients undergoing such surgery who receive PRBC are at risk for several adverse outcomes including increased mortality, atrial fibrillation, and more postoperative infections, as well as numerous other complications. The PubMed database was searched for the English language literature on the topic of PRBC transfusion and outcomes in patients undergoing cardiac surgery, as well as alternatives to this intervention. Data were reviewed to assess the impact of transfusion in patients undergoing cardiac surgery on mortality, cardiac, infectious, and pulmonary, as well as a variety of miscellaneous complications. Patients receiving PRBC were consistently identified as being at higher risk for complications in all categories. The limited prospective data were consistent with the retrospective data, which comprised most of the literature. The preponderance of the literature suggests that patients undergoing cardiac surgery can tolerate lower hemoglobin/hematocrit values than traditionally appreciated. Most published data also indicate that PRBC transfusion should be reserved for patients with an identifiable clinical/physiologic indication fir this intervention, consistent with recent specialty society guidelines.
输注红细胞悬液（PRBC）在接受心脏手术的患者中很常见。有大量证据表明，此类患者可以耐受相对较低的血红蛋白水平，并且已经有大量文献表明，接受此类手术的患者输注 PRBC 会有发生多种不良后果的风险，包括死亡率增加、心房颤动和更多的术后感染，以及许多其他并发症。在 PubMed 数据库中搜索了关于 PRBC 输注和接受心脏手术患者结局的英文文献，以及该干预措施的替代方法。对数据进行了回顾，以评估输血对接受心脏手术患者的死亡率、心脏、感染和肺部以及各种其他并发症的影响。输注 PRBC 的患者在所有类别中都被一致认为有更高的并发症风险。有限的前瞻性数据与包含大部分文献的回顾性数据一致。大多数文献表明，接受心脏手术的患者可以耐受比传统上认为的更低的血红蛋白/血细胞比容值。大多数已发表的数据还表明，PRBC 输血应保留给有明确临床/生理指征的患者，这与最近的专业学会指南一致。
