Holley A, Marks D C, Johnson L, Reade M C, Badloe J F, Noorman F
Department of Intensive Care Medicine, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia.
Anaesth Intensive Care. 2013 Jan;41(1):10-9. doi: 10.1177/0310057X1304100104.
The development of effective cryopreservation techniques for both red blood cells and platelets, which maintain ex vivo biological activity, in combination with frozen plasma, provides for a unique blood banking strategy. This technology greatly enhances the storage life of these products. The rationale and potential advantages of using cryopreservation techniques for the provision of blood products to remote and military environments have been effectively demonstrated in several conflicts over the last decade. Current haemostatic resuscitation doctrine for the exsanguinating patient supports the use of red blood cells, platelets and frozen plasma early in the resuscitation. We believe an integrated fresh-frozen blood bank inventory could facilitate provision of blood products, not only in the military setting but also in regional Australia, by overcoming many logistic and geographical challenges. The processes involved in production and point of care thawing are sufficiently well developed and achievable to make this technology a viable option. The potential limitations of cryopreservation and subsequent product thawing need to be considered if such a strategy is to be developed. A substantial body of international experience using cryopreserved products in remote settings has already been accrued. This experience provides a template for the possible creation of an Australian integrated fresh-frozen blood bank inventory that could conceivably enhance the care of patients in both regional Australia and in the military setting.
开发针对红细胞和血小板的有效冷冻保存技术，使其在体外保持生物活性，并与冷冻血浆相结合，提供了一种独特的血库策略。这项技术大大延长了这些产品的储存寿命。在过去十年的几场冲突中，已有效证明了使用冷冻保存技术为偏远地区和军事环境提供血液制品的基本原理和潜在优势。目前针对出血性休克患者的止血复苏原则支持在复苏早期使用红细胞、血小板和冷冻血浆。我们认为，通过克服许多后勤和地理挑战，一个整合的新鲜冷冻血库库存不仅可以在军事环境中，也可以在澳大利亚偏远地区促进血液制品的供应。生产和床边解冻所涉及的流程已经足够完善且可行，使这项技术成为一个可行的选择。如果要制定这样一个策略，需要考虑冷冻保存及后续产品解冻的潜在局限性。在偏远地区使用冷冻保存产品已经积累了大量国际经验。这一经验为创建澳大利亚整合新鲜冷冻血库库存提供了一个模板，这有望改善澳大利亚偏远地区和军事环境中患者的护理。
