围手术期患者输血相关急性肺损伤。
Transfusion-related Acute Lung Injury in the Perioperative Patient.
机构信息
From the Keenan Research Centre for Biomedical Science, St. Michael's Hospital, Toronto, Canada (M.J.M., J.W.S., W.M.K) Departments of Physiology and Anesthesia (M.J.M.) Pharmacology (J.W.S.) Laboratory Medicine-Pathobiology (C.C.-G.) Medicine-Division of Hematology (C.C.-G.) Anesthesia and Pain Management, University Health Network (K.K.) Physiology and Surgery (W.M.K.) University of Toronto, Toronto, Canada (C.C.-G.) Sickkids Department of Anesthesia and Pain Medicine (M.J.M.) Division of Hematology and Transfusion Medicine (R.K., J.W.S.), Lund University, Lund, Sweden Department of Experimental Immunohematology, Sanquin Research, and Landsteiner Laboratory, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands (R.K.) Departments of Laboratory Hematology (Blood Transfusion Laboratory), Laboratory Medicine Program (C.C.-G.) Medical Oncology and Hematology (C.C.-G.) University Health Network, Toronto, Canada (K.K.) Department of Clinical Pathology, Blood and Tissue Bank, Sunnybrook Health Sciences Centre, Toronto, Canada (C.C.-G.) Institute of Physiology, Charité University Berlin, Berlin, Germany (W.M.K.).
出版信息
Anesthesiology. 2019 Sep;131(3):693-715. doi: 10.1097/ALN.0000000000002687.
Transfusion-related acute lung injury is a leading cause of death associated with the use of blood products. Transfusion-related acute lung injury is a diagnosis of exclusion which can be difficult to identify during surgery amid the various physiologic and pathophysiologic changes associated with the perioperative period. As anesthesiologists supervise delivery of a large portion of inpatient prescribed blood products, and since the incidence of transfusion-related acute lung injury in the perioperative patient is higher than in nonsurgical patients, anesthesiologists need to consider transfusion-related acute lung injury in the perioperative setting, identify at-risk patients, recognize early signs of transfusion-related acute lung injury, and have established strategies for its prevention and treatment.
输血相关性急性肺损伤是与血液制品使用相关的主要死亡原因。输血相关性急性肺损伤是一种排除性诊断，在围手术期与各种生理和病理生理变化相关的情况下，在手术期间可能难以识别。由于麻醉师监督大部分住院患者规定的血液制品的输注，并且由于围手术期患者输血相关性急性肺损伤的发生率高于非手术患者，因此麻醉师需要在围手术期考虑输血相关性急性肺损伤，识别高危患者，识别输血相关性急性肺损伤的早期迹象，并制定其预防和治疗策略。
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