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我院心脏手术在患者血液管理方面的结果

The Results of Cardiac Surgery in Terms of Patient Blood Management in Our Hospital.

作者信息

Sert Gökçe Selçuk, Çavuş Mine, Kemerci Perihan, Bektaş Şerife, Demir Zeliha Aslı, Özgök Ayşegül, Sert Doğan, Karadeniz Ümit

机构信息

Clinic of Anaesthesiology and Reanimation, Türkiye Yüksek İhtisas Training and Research Hospital, Ankara, Turkey.

Clinic of Intensive Care, Türkiye Yüksek İhtisas Training and Research Hospital, Ankara, Turkey.

出版信息

Turk J Anaesthesiol Reanim. 2019 Oct;47(5):402-406. doi: 10.5152/TJAR.2019.02058. Epub 2019 May 22.

Abstract

OBJECTIVE

Clinic of Anaesthesiology and Reanimation, Türkiye Yüksek İhtisas Training and Research Hospital, beginning in 2014, the patient blood management (PBM) protocol is individualised based on patients' comorbidities, and the threshold for transfusion is 7 g dL of haemoglobin for patients without comorbidities and 8-9 g dL for patients with comorbidities. In this study, our aim was to compare patient outcomes, requirement for transfusion and the cost of transfusion between two different periods with and without PBM protocol.

METHODS

229 and 283 patients who underwent open-heart surgery using cardiopulmonary bypass during the first 4 months of 2012 and the first 4 months of 2017, respectively, were included in this retrospective, cross-sectional study.

RESULTS

There were no differences between the groups in preoperative data. Blood and blood product usage was observed to be significantly lower at the time of the PBM protocol. The use of packed red blood cells decreased from 2 units to 0and that of fresh frozen plasma decreased from 2 units to 0. In terms of postoperative mortality, there were no differences between the groups.

CONCLUSION

According to the results of this study, the transfusion of unnecessary blood and blood products was reduced and the cost decreased with PBM protocol. Blood product usage did not affect 30-day mortality. It will be possible to achieve more valuable results if more patients are assessed, PBM protocol is implemented and postoperative results are evaluated in detail.

摘要

目的

土耳其伊斯坦布尔医科大学培训与研究医院麻醉与复苏科自2014年起,根据患者的合并症制定个体化的患者血液管理(PBM)方案,无合并症患者的输血阈值为血红蛋白7 g/dL,合并症患者为8 - 9 g/dL。在本研究中,我们的目的是比较有无PBM方案的两个不同时期患者的结局、输血需求及输血成本。

方法

本回顾性横断面研究纳入了分别在2012年首4个月和2017年首4个月接受体外循环心脏直视手术的229例和283例患者。

结果

两组术前数据无差异。观察到在实施PBM方案时,血液及血液制品的使用显著减少。浓缩红细胞的使用从2单位降至0单位,新鲜冰冻血浆的使用从2单位降至0单位。术后死亡率方面,两组无差异。

结论

根据本研究结果,PBM方案减少了不必要的血液及血液制品输注,降低了成本。血液制品的使用不影响30天死亡率。如果评估更多患者、实施PBM方案并详细评估术后结果,将有可能取得更有价值的结果。

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