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重症监护病房患者输注一个单位的浓缩红细胞后血红蛋白水平的变化。

Changes in the hemoglobin level after one unit of packed red blood cell transfusion in Intensive Care Unit patients.

作者信息

Kashefi Parvis, Rahmani Amin, Khalifesoltani Maryam

机构信息

Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

Department of Anesthesiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

出版信息

J Res Med Sci. 2018 Sep 24;23:85. doi: 10.4103/jrms.JRMS_64_17. eCollection 2018.

Abstract

BACKGROUND

Blood transfusion is essential in severely ill patients whose hemoglobin (Hb) levels are low, but there are some factors that inhibit optimal increase in Hb. The aim of this study was to evaluate the amount of increase in Hb levels after packed red blood cell (PRBC) transfusions in the Intensive Care Unit (ICU) patients and its related factors.

MATERIALS AND METHODS

This cross-sectional study included 124 patients admitted to the ICU, and needed PRBC transfusion. Demographic information, Hb on the 1 day of admission, blood volume transfusions during the 7 days, and the 7 day of admission Hb level were extracted from patients' records.

RESULTS

The average initial Hb level of patients was reported as 6.17 ± 1.43 g/dl, and after administrating PRBC (4.23 ± 1.87 units during 7 days), the Hb level was 8.09 ± 1.66 g/dl after 7 days (mean difference was 1.91 ± 1.93, = 11.06, < 0.001). No significant differences were found between change in Hb level in the terms of age, gender, underlying illness, body mass index, hospitalization history, fever, and duration of hospitalization ( > 0.05). However, the mean increased Hb level in hospitalized patients with internal disorders was the lowest (0.25 g/dl, = 0.002).

CONCLUSION

The results of our study showed that the increased Hb level based on one unit of received PRBC was low, especially in patients with internal. Therefore, based on high frequency of anemia in ICU patients and relative complications, physicians should pay attention to factors affecting Hb levels after PRBC transfusion such as medical history.

摘要

背景

对于血红蛋白(Hb)水平较低的重症患者,输血至关重要,但存在一些因素会抑制 Hb 的最佳升高。本研究的目的是评估重症监护病房(ICU)患者输注浓缩红细胞(PRBC)后 Hb 水平的升高量及其相关因素。

材料与方法

这项横断面研究纳入了 124 名入住 ICU 且需要输注 PRBC 的患者。从患者记录中提取人口统计学信息、入院第 1 天的 Hb、7 天内的输血量以及入院第 7 天的 Hb 水平。

结果

患者的平均初始 Hb 水平报告为 6.17 ± 1.43 g/dl,在输注 PRBC(7 天内 4.23 ± 1.87 单位)后,7 天后 Hb 水平为 8.09 ± 1.66 g/dl(平均差异为 1.91 ± 1.93, = 11.06, < 0.001)。在 Hb 水平变化方面,年龄、性别、基础疾病、体重指数、住院史、发热和住院时间之间未发现显著差异( > 0.05)。然而,患有内科疾病的住院患者的平均 Hb 升高水平最低(0.25 g/dl, = 0.002)。

结论

我们的研究结果表明,基于每单位输注的 PRBC,Hb 升高水平较低,尤其是在内科患者中。因此,鉴于 ICU 患者贫血的高发生率和相关并发症,医生应关注 PRBC 输血后影响 Hb 水平的因素,如病史。

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