Zielinski Martin D, Schrager Jason J, Johnson Pamela, Stubbs James R, Polites Stephanie, Zietlow Scott P, Jenkins Donald H, Robinson Bryce R H
Department of Surgery, Mayo Clinic, Rochester, Minnesota, USA.
Clin Transl Sci. 2015 Feb;8(1):43-7. doi: 10.1111/cts.12206. Epub 2014 Sep 9.
Group AB plasma, the traditional universal donor plasma product, is a limited resource. We compared outcomes of Group A plasma transfusion in comparison to AB.
Analysis of blunt-injured patients who received emergency release plasma from was performed. Multivariable logistic regression was utilized to identify associations with morbidity and mortality.
There were 191 patients; 115 Group A and 76 Group AB. No differences were seen in age, sex, plasma transfusions, uncrossmatched red blood cells (RBCs), and Glasgow Coma Scale (GCS). Patients who received Group A plasma had significantly lower Injury Severity Score, chest Abbreviated Injury Scale (AIS), and scene transfer rate but not head AIS, or abdomen AIS. In addition, significant differences were noted in terms of blood products transfused within 24 hours in those receiving Group A over AB. Development of acute respiratory distress syndrome (ARDS), but not mortality, was higher within the AB cohort. No hemolytic or transfusion associated-ARDS reactions were noted in either group. ARDS; RBC transfusion volumes and head AIS were independently associated with mortality.
Utilization of Group A plasma for emergency blood resuscitation is a safe option which may alleviate potential shortages of AB plasma.
AB型血浆，传统的通用供体血浆产品，是一种有限的资源。我们比较了输注A型血浆与AB型血浆的结果。
对接受紧急发放血浆的钝性损伤患者进行分析。采用多变量逻辑回归来确定与发病率和死亡率的关联。
共有191例患者；115例为A型组，76例为AB型组。在年龄、性别、血浆输注量、未交叉配型的红细胞（RBC）以及格拉斯哥昏迷量表（GCS）方面未发现差异。接受A型血浆的患者损伤严重程度评分、胸部简明损伤量表（AIS）和现场转运率显著较低，但头部AIS或腹部AIS无差异。此外，接受A型血浆的患者在24小时内输注的血液制品与接受AB型血浆的患者存在显著差异。AB型组急性呼吸窘迫综合征（ARDS）的发生率较高，但死亡率无差异。两组均未观察到溶血或输血相关的ARDS反应。ARDS、RBC输注量和头部AIS与死亡率独立相关。
使用A型血浆进行紧急血液复苏是一种安全的选择，可能缓解AB型血浆的潜在短缺。
