Pusateri Anthony E, Given Michael B, Schreiber Martin A, Spinella Philip C, Pati Shibani, Kozar Rosemary A, Khan Abdul, Dacorta Joseph A, Kupferer Kevin R, Prat Nicolas, Pidcoke Heather F, Macdonald Victor W, Malloy Wilbur W, Sailliol Anne, Cap Andrew P
US Army Medical Research and Materiel Command, Fort Detrick, Maryland.
Office of Naval Research, Arlington, Virginia.
Transfusion. 2016 Apr;56 Suppl 2:S128-39. doi: 10.1111/trf.13580.
The early transfusion of plasma is important to ensure optimal survival of patients with traumatic hemorrhage. In military and remote or austere civilian settings, it may be impossible to move patients to hospital facilities within the first few hours of injury. A dried plasma product with reduced logistical requirements is needed to enable plasma transfusion where medically needed, instead of only where freezers and other equipment are available. First developed in the 1930s, pooled lyophilized plasma was widely used by British and American forces in WWII and the Korean War. Historical dried plasma products solved the logistical problem but were abandoned because of disease transmission. Modern methods to improve blood safety have made it possible to produce safe and effective dried plasma. Dried plasma products are available in France, Germany, South Africa, and a limited number of other countries. However, no product is available in the US. Promising products are in development that employ different methods of drying, pathogen reduction, pooling, packaging, and other approaches. Although challenges exist, the in vitro and in vivo data suggest that these products have great potential to be safe and effective. The history, state of the science, and recent developments in dried plasma are reviewed.
早期输注血浆对于确保创伤性出血患者的最佳存活率至关重要。在军事以及偏远或条件简陋的民用环境中，受伤后的最初几个小时内可能无法将患者转移到医院设施。需要一种对后勤要求较低的冻干血浆产品，以便在医疗需要的地方进行血浆输注，而不是仅在有冷冻设备和其他器材的地方。冻干血浆最早于20世纪30年代研发出来，二战和朝鲜战争期间被英美军队广泛使用。历史上的冻干血浆产品解决了后勤问题，但因疾病传播而被弃用。现代提高血液安全性的方法使得生产安全有效的冻干血浆成为可能。法国、德国、南非和其他一些国家有冻干血浆产品供应。然而，美国没有此类产品。目前正在研发一些有前景的产品，采用了不同的干燥、病原体灭活、混合、包装及其他方法。尽管存在挑战，但体外和体内数据表明，这些产品具有安全有效的巨大潜力。本文对冻干血浆的历史、科学现状及近期进展进行了综述。
