Tavousi S H, Ahmadabadi A, Sedaghat A, Khadem-Rezaiyan M, Yaghoubi Moghaddam Z, Behrouzian M J, Nemati S, Saghafi H
Surgical Oncology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
Surgical Oncology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
Transfus Clin Biol. 2018 Feb;25(1):58-62. doi: 10.1016/j.tracli.2017.07.003. Epub 2017 Aug 31.
Blood and its derivatives are one of the most lifesaving products in the modern medicine practice. However, it is not an absolutely safe prescription. Many adverse effects such as infection, transfusion-related acute lung injury, immunosuppression, multi-organ dysfunction, acute respiratory syndrome, transfusion errors, transmission of infectious agents such as HIV, HBV, HCV are attributable to blood transfusion. The aim of this study was to describe how and when blood products were transfused in a referral burn center.
This cross-sectional study was performed on medical records of all admitted patients in the Department of Burns and Reconstructive Surgery of Imam Reza Hospital, Mashhad, Iran during September 2014 up to August 2015. Transfusion measures such as Hb, Hct and demographic data were extracted from patient records. SPSS version 11.5 was used for data analysis.
During the study period, 701 acute burnt patients were admitted with the mean age of 25.5±20.5 years. Sixty-four percent were male and burnt percentage of total body surface area (TBSA) was 30.9±24.3%. About one third (240) of patients received at least one blood product. Mean of the transfused packed red blood cell was 274.1±674.6mL per patient and 8.85mL per 1% of burnt TBSA. Anemia was the most common transfusion trigger.
Mortality in burnt patients who received blood products was two folds more than patients who did not receive any blood products. We prescribed less blood products compared with other reviewed burn centers. However, following a written blood transfusion protocol by all clinicians may reduce blood transfusion in unnecessary situations even more significantly.
血液及其衍生物是现代医学实践中最能挽救生命的产品之一。然而，它并非绝对安全的治疗手段。许多不良反应，如感染、输血相关急性肺损伤、免疫抑制、多器官功能障碍、急性呼吸综合征、输血错误、传染性病原体（如HIV、HBV、HCV）传播等都归因于输血。本研究的目的是描述在一家转诊烧伤中心血液制品的输注方式和时间。
本横断面研究对2014年9月至2015年8月期间伊朗马什哈德伊玛目礼萨医院烧伤与重建外科收治的所有患者的病历进行。从患者记录中提取诸如血红蛋白（Hb）、血细胞比容（Hct）等输血指标以及人口统计学数据。使用SPSS 11.5版进行数据分析。
在研究期间，共收治701例急性烧伤患者，平均年龄25.5±20.5岁。64%为男性，全身烧伤总面积（TBSA）为30.9±24.3%。约三分之一（240例）患者接受了至少一种血液制品。每位患者输注的浓缩红细胞平均量为274.1±674.6mL，每1%烧伤TBSA输注量为8.85mL。贫血是最常见的输血诱因。
接受血液制品的烧伤患者死亡率是未接受任何血液制品患者的两倍。与其他经审查的烧伤中心相比，我们开具的血液制品较少。然而，所有临床医生遵循书面输血方案可能会更显著地减少不必要情况下的输血。
