武装部队血库计划：2001 年至 2011 年的战斗伤员救治血液保障。
The Armed Services Blood Program: blood support to combat casualty care 2001 to 2011.
机构信息
Armed Services Blood Program Office, Falls Church, Virginia, USA.
出版信息
J Trauma Acute Care Surg. 2012 Dec;73(6 Suppl 5):S472-8. doi: 10.1097/TA.0b013e31827546e4.
BACKGROUND
The Armed Services Blood Program (ASBP) provides the farthest-reaching blood supply in the world. This article provides statistics and a review of blood operations in support of combat casualty care during the last 10 years. It also outlines changes in blood doctrine in support of combat casualty care.
METHODS
This is a descriptive overview and review of blood product use and transfusions used by ASBP personnel to support combat operations in Iraq and Afghanistan between October 2001 and November 2011.
RESULTS
The ASBP initiated major changes in blood availability and age of blood in theater. In support of data published by physicians in theater, showing improved patient survival when a higher ratio of fresh frozen plasma and red blood cells (RBCs) is achieved, plus the use of platelets, the ASBP increased availability of plasma and established platelet collection facilities in theater. New capabilities included emergency collection of apheresis platelets in the battlefield, availability and transfusion of deglycerolized red cells, rapid diagnostic donor screening, and a new modular blood detachment. Forward surgical facilities that were at one time limited to a blood inventory consisting of RBCs now have a complete arsenal of products at their fingertips that may include fresher RBCs, fresh frozen plasma, cryoprecipitate, and platelets. A number of clinical practice guidelines are in place to address these processes. Changes in blood doctrine were made to support new combat casualty care and damage-control resuscitation initiatives.
CONCLUSION
Despite the challenges of war in two theaters of operation, a number of improvements and changes to blood policy have been developed during the last 10 years to support combat casualty care. The nature of medical care in combat operations will continue to be dynamic and constantly evolving. The ASBP needs to be prepared to meet future challenges.
LEVEL OF EVIDENCE
Epidemiologic study, level IV.
背景
武装部队血库计划（ASBP）提供了全球范围最广的血液供应。本文提供了过去 10 年来支持战斗伤员救治的血液作业统计数据和回顾，概述了支持战斗伤员救治的血液理论变化。
方法
这是对 2001 年 10 月至 2011 年 11 月期间 ASBP 人员支持伊拉克和阿富汗作战行动中使用血液制品和输血的描述性概述和回顾。
结果
ASBP 启动了血液供应和血液年龄的重大变化。为了支持在战区发布的医生数据，表明当更高比例的新鲜冷冻血浆和红细胞（RBC）以及血小板得到实现时，患者的生存率得到提高，ASBP 增加了血浆的供应，并在战区建立了血小板采集设施。新能力包括在战场上紧急采集单采血小板、使用去甘油化红细胞、快速诊断供体筛选以及新的模块化血液分离单位。曾经仅限于库存 RBC 的前线外科设施现在可以在指尖上获得完整的武器库，其中可能包括更新鲜的 RBC、新鲜冷冻血浆、冷沉淀和血小板。已经制定了许多临床实践指南来解决这些问题。血液理论的变化是为了支持新的战斗伤员救治和损伤控制性复苏计划。
结论
尽管在两个战区作战存在挑战，但在过去 10 年中，已经制定了一些改进和血液政策变化，以支持战斗伤员救治。战斗行动中的医疗保健性质将继续具有动态性和不断发展。ASBP 需要做好准备应对未来的挑战。
证据水平
流行病学研究，四级。
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