Page Catherine, Retter Andrew, Wyncoll Duncan
Intensive Care Unit, Guy's and St. Thomas' Foundation Trust, Lambeth Palace Road, London SE1 7EH, UK.
Ann Intensive Care. 2013 May 28;3:14. doi: 10.1186/2110-5820-3-14. eCollection 2013.
Anaemia is associated with inferior outcomes in critically ill patients. It is difficult to prevent and is treated commonly with the transfusion of packed red cells. However, transfusion to augment oxygen delivery has not been shown to consistently offer a survival advantage when the haemoglobin concentration exceeds 7 g/dL. Several studies point to inferior outcomes when patients are transfused. Observational studies have confirmed that critically ill patients have frequent blood draws as part of their routine daily care. Cumulatively large volumes of blood are frequently taken, which contribute significantly towards the development of anaemia. Reducing iatrogenic blood loss may reduce the risk of developing anaemia and possibly the need for transfusion. Blood conservation devices may help to achieve this goal. The integration of blood conservation devices into routine care has been relatively slow in critical care. This review summarises the current evidence base and confirms that blood conservation devices do reduce the volume of iatrogenic blood loss. In the most recent studies, these devices have been shown to reduce transfusion requirements even in those intensive care units that follow a restrictive transfusion strategy.
贫血与危重症患者的不良预后相关。贫血难以预防，通常采用输注浓缩红细胞进行治疗。然而，当血红蛋白浓度超过7 g/dL时，通过输血增加氧输送并未始终显示出具有生存优势。多项研究表明，患者接受输血时预后较差。观察性研究证实，危重症患者在日常常规护理中经常进行采血。累计采血量往往很大，这对贫血的发生有很大影响。减少医源性失血可能会降低发生贫血的风险，并可能减少输血需求。血液保护装置可能有助于实现这一目标。在重症监护中，将血液保护装置整合到常规护理中的进程相对缓慢。本综述总结了当前的证据基础，并证实血液保护装置确实能减少医源性失血量。在最近的研究中，这些装置已被证明即使在遵循限制性输血策略的重症监护病房中也能减少输血需求。
