Carson Jeffrey L, Strair Roger
Division of General Internal Medicine, Rutgers Robert Wood Johnson Medical School, and.
Section of Hematologic Malignancies, Rutgers Cancer Institute of New Jersey, Rutgers Biomedical and Health Sciences, Rutgers, The State University of New Jersey, New Brunswick, NJ.
Hematology Am Soc Hematol Educ Program. 2014 Dec 5;2014(1):548-52. doi: 10.1182/asheducation-2014.1.548. Epub 2014 Nov 18.
Substantial progress has been made in our understanding of the risks and benefits of RBC transfusion through the performance of large clinical trials. More than 7000 patients have been enrolled in trials randomly allocating patients to higher transfusion thresholds (∼9-10 g/dL), referred to as liberal transfusion, or lower transfusion thresholds (∼7-8 g/dL), referred to as restrictive transfusion. The results of most of the trials suggest that a restrictive transfusion strategy is safe and, in some cases, superior to a liberal transfusion strategy. However, in patients with myocardial infarction, brain injury, stroke, or hematological disorders, more large trials are needed because preliminary evidence suggests that liberal transfusion might be beneficial or trials have not been performed at all.
通过开展大型临床试验，我们在了解红细胞输血的风险和益处方面取得了重大进展。超过7000名患者参与了试验，这些试验将患者随机分配至较高输血阈值（约9 - 10 g/dL），即宽松输血策略，或较低输血阈值（约7 - 8 g/dL），即限制性输血策略。大多数试验结果表明，限制性输血策略是安全的，并且在某些情况下优于宽松输血策略。然而，对于心肌梗死、脑损伤、中风或血液系统疾病患者，还需要更多大型试验，因为初步证据表明宽松输血可能有益，或者根本尚未开展相关试验。
