Parimi Nehu, Fontaine Magali J, Yang Shiming, Hu Peter F, Li Hsiao-Chi, Mackenzie Colin F, Kozar Rosemary A, Miller Catriona, Scalea Thomas M, Stein Deborah M
Shock Trauma and Anesthesiology Research Organized Research Center (STAR-ORC).
Department of Pathology, University of Maryland School of Medicine, Baltimore, MD, USA
Ann Clin Lab Sci. 2018 May;48(3):279-285.
Establishing transfusion guidelines during trauma resuscitation is challenging. Our objective was to evaluate indications for transfusion in trauma patients who emergently received ≤2 units of red blood cells (RBC) during the first hour of resuscitation.
A single center retrospective study included non-massively bleeding trauma patients stratified into 2 groups: 1) with a clinical indication for transfusion and 2) with no indication for transfusion. Admission vital signs (VS), injury severity score (ISS), shock index, and laboratory values were compared between the two groups using the Wilcoxon rank-sum test.
Among 111 non-massively bleeding trauma patients, 40 presented no indication for transfusion. All patients presented similar ISS and VS. The 71 patients presenting with an indication for transfusion had higher bicarbonate (22.6 vs 20.8) and lower lactate levels (4.7 v 6.6) (<0.05).
Lactate and bicarbonate blood levels may be potential indicators for RBC transfusion need during trauma resuscitation in non-massively bleeding patients.
在创伤复苏过程中制定输血指南具有挑战性。我们的目标是评估在复苏的第一个小时内紧急接受≤2单位红细胞（RBC）的创伤患者的输血指征。
一项单中心回顾性研究纳入了非大量出血的创伤患者，分为两组：1）有输血临床指征的患者和2）无输血指征的患者。使用Wilcoxon秩和检验比较两组患者的入院生命体征（VS）、损伤严重程度评分（ISS）、休克指数和实验室值。
在111例非大量出血的创伤患者中，40例无输血指征。所有患者的ISS和VS相似。有输血指征的71例患者的碳酸氢盐水平较高（22.6对20.8），乳酸水平较低（4.7对6.6）（<0.05）。
对于非大量出血患者，在创伤复苏期间，血液中的乳酸和碳酸氢盐水平可能是需要输注红细胞的潜在指标。
