小儿先天性心脏病体外循环手术中血制品输注的审计
Audit of transfusion of blood products in paediatric congenital heart surgery on cardiopulmonary bypass.
作者信息
Bayebaye Caroline Tumelo, Muteba Michel Kasongo, Chakane Palesa Motshabi
机构信息
Department of Anaesthesiology, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Division of Epidemiology and Biostatistics, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.
出版信息
Cardiovasc J Afr. 2018;29(6):381-386. doi: 10.5830/CVJA-2018-048. Epub 2018 Nov 6.
BACKGROUND
Cardiac surgery is associated with peri-operative bleeding, which may result in the need for blood transfusion, particularly in paediatric congenital cardiac surgery on cardiopulmonary bypass (CPB). There is a necessity for regular auditing in order to improve practices.
METHODS
Retrospective, contextual, descriptive data of 105 patients were collected for the period January to December 2014.
RESULTS
The median age of patients was four (1-6) years, weight was 13 (8.4-20) kg, and mean lowest CPB haemoglobin level was 8.3 (1.5) g/dl. There was a statistically significant difference in median red packed cell (RPC), platelet and cryoprecipitate units per patient transfused across four RACHS (risk-adjusted classification for congenital heart surgery) categories ( = 0.03, = 0.0013, = 0.0001, respectively). There was a statistically significant correlation between transfused fresh frozen plasma units with CPB time ( = 0.2634, = 0.0199) and RPC units ( = -0.4654, < 0.001).
CONCLUSIONS
Although no standardised transfusion guidelines were available, overall transfusion of blood products was comparable to reported practices.
背景
心脏手术与围手术期出血相关，这可能导致需要输血，尤其是在小儿先天性心脏手术的体外循环（CPB）中。为了改进操作，定期审计很有必要。
方法
收集了2014年1月至12月期间105例患者的回顾性、背景性、描述性数据。
结果
患者的中位年龄为4（1 - 6）岁，体重为13（8.4 - 20）千克，体外循环期间最低血红蛋白水平平均为8.3（1.5）克/分升。在四个先天性心脏病手术风险调整分类（RACHS）类别中，每位患者输注的红细胞悬液（RPC）、血小板和冷沉淀单位数存在统计学显著差异（分别为P = 0.03、P = 0.0013、P = 0.0001）。输注的新鲜冰冻血浆单位数与体外循环时间（P = 0.2634，P = 0.0199）和红细胞悬液单位数（P = -0.4654，P < 0.001）之间存在统计学显著相关性。
结论
尽管没有标准化的输血指南，但血液制品的总体输血情况与报告的做法相当。
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